Should a Facelift and Neck Lift Be Done Together? A Deep Plane Expert’s Analysis
2025-12-11
Achieving Natural Results by Connecting the SMAS and Platysma Muscle
Hello, I am Dr. Park, the director of Noonopi Plastic Surgery.
During consultations, many patients focus solely on sagging facial skin and ignore neck wrinkles.
A common sentiment I hear is,
“I'll just fix the neck later if I need to.”
However, from an anatomical perspective, the face and neck are not separate tissues.
In this article, I will explain why a holistic approach, treating the face and neck simultaneously, is crucial for achieving natural-looking anti-aging results.
I will also outline the core surgical principles involving the SMAS and platysma muscles, which are vital for understanding high-quality lifting surgery.
1. Why Performing a Facelift Alone Can Lead to Unnatural Results
Patients often worry about side effects such as "pixie ears" or visible scars. However, fewer patients are warned about "facial disharmony," which occurs when a facelift is performed without addressing the neck.
Renowned plastic surgeon Sam T. Hamra emphasized the importance of composite rhytidectomy and continuous dissection of the SMAS and platysma. This is because the facial SMAS and the neck muscle (platysma) are anatomically connected as a single unit.
If only the facial skin is lifted upward while leaving the sagging neck muscles untouched, the following issues arise:
- Visual age gap:
The face looks taut and youthful while the neck remains wrinkled and aged. This contrast makes the surgery look obvious and unnatural. - Irregular Jawline:
The skin below the ears may bunch up ("dog ears"), creating an uneven jawline. - Reduced Longevity:
The heavy, sagging platysma muscle in the neck pulls downward. If not released, it reduces the lifting effect on the face, causing the SMAS to stretch back out sooner. - Complexity of Revision Surgery:
If you decide to get a neck lift years after a facelift, the surgeon must reopen areas with existing scar tissue. This significantly increases the difficulty and risk of the procedure. (Related: Why a Simultaneous Facelift and Neck Lift is Recommended)
The Solution
For dramatic and natural improvement of the lower face, the gold standard is repositioning the entire connected tissue layer via a combined facelift and neck lift.
This is a before-and-after comparison of a facelift alone versus a combined face and neck lift, showing the difference in sharp jawline definition.
2. The Core Technique: Tightening the "Deep Plane," Not Just the Skin
Simply cutting and tightening the outer skin results in a "windblown" look and rapid relapse. As experts emphasize, the key to a successful lift lies in the deep plane.
- SMAS Facelift :
We dissect the deep SMAS layer beneath the skin, lift it back to its youthful position, and firmly secure it.
- Neck lift (corset platysmaplasty):
The platysma muscle is separated from the surrounding tissues to release downward tension. Then, we perform corset platysmaplasty, stitching the neck muscles tight (like a corset) to sharpen the angle. We also remove deep neck fat to eliminate double chins and define the jawline.
At Noonopi Clinic, we advocate for this integrated solution. By dissecting and tightening both layers simultaneously, we ensure natural facial expressions and long-lasting lifting effects.
3. Honest Answers: Scars and Recovery Timeline
We believe in being transparent about the two most common patient concerns: Scars and downtime.
Visible Scars
The incision follows the natural curve in front of the ear and extends into the hairline behind the ear.
Six+ months: Because the incision is meticulously placed within the natural creases of the ear (the tragus and helix), it becomes nearly invisible to the naked eye over time.
Click here to learn more about where the incision for a facelift is placed.
Recovery Period:
- Two weeks:
Major bruising and swelling typically subside within two weeks. Most patients return to daily social activities and work after 10–14 days, wearing makeup. - Three to six months:
Residual swelling softens and tissues settle into their final, natural shape.
🤫Expert note:
Instead of ads promising "recovery in just three days," it's important to allow ample recovery time to achieve the best possible results. You've already made the big decision to undergo surgery. Shouldn't you prioritize lasting, positive outcomes over a quick recovery?
4. Who Needs This Surgery? (Candidate Selection)
A surgical lift is not for everyone.
- Non-surgical candidates:
If you have minimal sagging and are mostly concerned with skin elasticity, energy-based devices such as Ultherapy, Thermage, or thread lifts may suffice. - Surgical candidates:
If you have significant skin laxity, deep folds (jowls), or a collapsed jawline that makes your face appear square, non-surgical methods will produce limited results.
The Importance of Accurate Diagnosis
The first step is determining whether you need a dermatological procedure or surgical intervention.
The Noonopi Promise: Why Perfection Takes Time
- Meticulous Finishing:
From incision design to the final suture, I personally perform every step. There is no "shadow doctor" or delegation. - Quality Over Quantity:
We do not compromise on time to lower prices or increase patient volume. A high-quality facelift requires time and focus. The time I dedicate to you directly reflects the quality of your results. - Avoiding Revision:
"The most expensive surgery is a second surgery." The emotional toll and financial cost of correcting botched surgery are immense. My goal is to perform the surgery perfectly the first time, so you never have to worry about a revision. This is why I insist on simultaneously correcting the face and neck.
If you have questions about your specific condition, please contact us via 📲WhatsApp.
As the director, I personally review all inquiries to provide the most accurate advice.
