Facelift vs. Neck Lift: How to Know Which Procedure You Need

Deciding between a facelift and a neck lift comes down to where your signs of aging show up most: a facelift addresses sagging skin, jowls, and volume loss across the mid and lower face, while a neck lift targets loose skin, vertical banding, and fullness beneath the jawline. Dr. James M. Ridgway, a double board-certified facial plastic surgeon exclusively dedicated to the face and neck, evaluates each patient's unique anatomy to determine which procedure, or combination, will deliver the most natural, balanced result.

In this blog, we'll discuss what each procedure treats, how they differ, whether they can be combined, and the signs that indicate which one might be right for you.

What Does a Facelift Address?

A facelift is a surgical procedure designed to improve visible signs of aging across the face by repositioning deeper facial tissue rather than simply pulling the skin tight. According to the American Society of Plastic Surgeons, a facelift, or rhytidectomy, improves visible signs of aging such as sagging skin and deepening fold lines between the nose and mouth. Common concerns a facelift resolves include:

• Sagging or loose skin along the cheeks and jawline.
• Deep nasolabial folds between the nose and mouth.
• Loss of youthful facial contours and volume.
• Jowls that disrupt a clean jawline.

These changes stem from more than just gravity. Thinning skin, loss of facial fat, sun damage, smoking, heredity, and stress can all contribute to the loss of youthful facial contours. Because a facelift lifts the underlying muscle and connective tissue layer rather than the skin alone, results tend to look refreshed instead of stretched.

What Does a Neck Lift Address?

A neck lift focuses specifically on the area below the chin and jawline, correcting concerns a facelift alone won't fully resolve. Excess wrinkling of the neck skin, a double chin or "turkey wattle," and jowl lines often appear when the neck no longer matches the appearance of the upper face. A neck lift is often recommended for:

• Loose, crepey skin beneath the chin and along the jawline.
• Vertical muscle banding, sometimes called "turkey neck".
• Excess fat or fullness under the chin.
• A poorly defined angle between the jaw and neck.

The neck ages differently than the rest of the face. A neck lift removes excess neck skin and lifts sagging soft tissue known as the SMAS layer, which is the same fibrous support structure a facelift addresses higher up the face.

Facelift vs. Neck Lift: Key Differences

Although both procedures share surgical techniques, they solve different problems and are often judged by different results. Some patients need one, some need the other, and many benefit from both performed together. Key distinctions include:

• Facelifts primarily treat the cheeks, jawline, and lower face; neck lifts primarily treat the area beneath the jaw.
• Facelifts reduce nasolabial folds and jowls; neck lifts reduce banding and submental fullness.
• A neck lift alone will not correct sagging in the mid-face.
• A facelift alone may not fully resolve loose neck skin if it's already significantly aged.

One surgeon has noted candidly that he wouldn't necessarily recommend someone undergo a facelift or neck lift purely to try to prevent future aging; timing and degree of visible aging matter more than age alone.

Can a Facelift and Neck Lift Be Combined?

Many patients don't have to choose one or the other. Because the neck and lower face share connected tissue layers, combining both procedures often creates a more balanced, harmonious outcome than treating either area alone. Reasons patients choose to combine them include:

• Aging is visible in both the jawline and the neck simultaneously.
• A neck lift alone would leave the neck looking younger than the face.
• Combining procedures means one recovery period instead of two.
• Complementary treatments like a brow lift or eyelid surgery can be added in the same surgical session.

The American Society of Plastic Surgeons notes that a neck lift is a restorative surgery that cannot stop the aging process on its own, which is part of why many surgeons plan the neck and lower face together rather than in isolation.American Society of Plastic Surgeons

Signs You May Need a Facelift, a Neck Lift, or Both

Identifying where your aging concerns are concentrated is the clearest way to determine which procedure fits your goals. Consider the following:

• If your main concerns are jowls, nasolabial folds, and sagging cheeks, a facelift alone may be sufficient.
• If your main concern is loose skin, fullness, or banding under the chin with a youthful-looking upper face, a neck lift alone may be enough.
• If both areas show noticeable aging, a combined procedure typically produces the most natural, proportional result.
• If you're unsure, a personalized evaluation is the only reliable way to know for certain.

Dr. Ridgway's dual board certification and fellowship training in facial plastic and reconstructive surgery at the University of Washington give him a comprehensive understanding of how the face and neck age together, allowing him to recommend the procedure — or combination — that fits your anatomy rather than a one-size-fits-all approach.

Ready to Find Out Which Procedure Is Right for You?

Choosing between a facelift and a neck lift doesn't have to be a guessing game. With a thorough evaluation of your facial structure, skin quality, and aesthetic goals, Dr. James M. Ridgway can help you determine whether a facelift, a neck lift, or a combination of both will deliver the natural, refreshed results you're looking for. Schedule a consultation with Dr. Ridgway today to build a personalized plan for your face and neck.