Video calls did one thing mirrors by no means did. They confirmed individuals their very own faces from under, for hours a day, and lots of didn’t just like the view of their necks and jawlines. The American Society of Plastic Surgeons recorded a 2 % rise in neck lifts in 2024, double the 1 % progress in facelifts.
At FACES+ in San Diego, Dr. Steven R. Cohen treats the neck as a separate anatomical downside fairly than an extension of the face.
4 layers, 4 causes
A unfastened or heavy neck can come from any mixture of the next:
Pores and skin that has misplaced elasticity via age, solar or weight reduction.
Fats, both just below the pores and skin or deeper beneath the platysma muscle.
Muscle, when the platysma separates and types the vertical bands many individuals discover as they age.
Glands, when the submandibular salivary glands descend and create fullness below the jaw that no quantity of weight reduction modifications.
Every trigger wants a unique repair, which is why a neck handled with one software so usually disappoints.

Matching the therapy to the layer
When extra fats sits just below the pores and skin and the pores and skin nonetheless has good tone, FACES+ can use jawline and neck liposuction to sharpen the profile with little downtime.
When muscle bands are the difficulty, a platysmaplasty tightens the platysma to easy the vertical traces and redefine the angle below the jaw.
When pores and skin has loosened, the follow performs a decrease rhytidectomy, the normal neck carry, working via incisions behind the ears and below the chin to carry and tighten pores and skin, fats and muscle collectively.
When deep fats or distinguished glands trigger the fullness, FACES+ gives deep neck and submandibular gland discount. Floor liposuction can’t attain tissue below the muscle, so sufferers who’ve tried it with out success are sometimes on this group.
The follow states that each neck carry Cohen performs is personalized to the person. In follow which means the surgeon decides which layers to deal with earlier than selecting a process title.
Why the neck modifications the entire consequence
A refreshed face above an unchanged neck appears to be like mismatched. The reverse can also be true: a sharper jawline could make a face learn years youthful with none work above it. Cohen evaluates the neck in each facelift session and treats all its layers the place wanted, which FACES+ describes as a core a part of its California facelift strategy.
The neck additionally fits sufferers, males amongst them, who desire a firmer jawline with out the broader change of a full facelift.
Restoration
FACES+ tells neck carry sufferers to count on swelling and bruising within the first week and to put on a compression garment for one to 2 weeks. Most return to gentle exercise after 10 to 14 days. The ultimate contour takes a number of months to look as swelling subsides and tissues settle.
Who’s a candidate
The follow describes good candidates as individuals with substantial unfastened pores and skin within the neck from getting old, weight reduction or genetics. Sufferers with fullness however agency pores and skin could do nicely with liposuction alone. Heavy vertical bands, a “turkey neck” and jowls that spill under the jawline have a tendency to wish surgical procedure.
What to ask
Deliver one query to any session: which layers of my neck trigger what I see? A surgeon who can reply that layer by layer may even be capable of let you know whether or not liposuction alone would depart unfastened pores and skin, whether or not you want gland or deep fats discount, and whether or not your neck needs to be handled along with your face or by itself.
Cohen is a board-certified plastic surgeon, a medical professor at UC San Diego, and a member of Newsweek’s America’s Greatest Plastic Surgeons record. FACES+ has practiced in San Diego since 1999.

