Z Facial Plastic Surgery

Neck Lift in Miami

Introduction To Neck Lift

At our state-of-the-art south Florida practice, nestled between Fort Lauderdale and Miami in Aventura, neck lift is a very popular procedure and one of Dr. Z’s specialties. The neck area develops several different issues as we age, including a “sagging” or “drooping” appearance with loose skin and folds. As this is also one of the most exposed areas on our bodies and difficult to disguise, especially in south Florida, the neck lift is many times the best procedure to help rejuvenate and improve the appearance of the neck. It is also very important to note that a neck lift by itself may not always be the only option, and so this might need to be combined with additional procedures to achieve the best results.

Dr. Z has worked hard to make the information on this page clear and concise so that patients can gain an understanding of the neck lift procedure, as well as their alternative and adjunctive options. To schedule a consultation with Dr. Z for a Miami neck lift and/or neck evaluation, please contact us today. Dr. Z, will listen to your aesthetic goals, examine your specific neck issues, and give you his expert recommendations on how to best achieve your desired aesthetic goals.

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black top | neck lift | Dr. Z Facial Plastic Surgery

What is a Neck Lift?

A neck lift is a cosmetic surgical procedure that removes excess neck skin, tightens/suspends the underlying support tissues, and removes excess fat when appropriate. This procedure varies between patients depending on their specific anatomy and aesthetic goals. A neck lift can be either isolated underneath the neck with a platysmaplasty, a direct neck with excision of skin from the center or performed like the lower portion of a facelift type procedure. While the details are described under the “Neck Lift Procedure” section, the goal is to reverse the signs of aging and improve the contours of the neck by tightening the muscles and removing extra skin. It can be performed under general anesthesia or awake with local numbing and anti-anxiety medication.

Who are the Best Candidates for a Neck Lift?

Dr. Z believes in achieving the most significant results with the least invasive method possible, thus the best candidates are those that cannot achieve the desired results with an alternative modality. This includes individuals with any of the following:

  • Moderate to severe skin excess and sagging
  • Platysmal bands (two vertical lines near the midline)
  • Excess fullness (deep to platysma) that cannot be addressed with neck liposuction
eyes closed | neck lift | Dr. Z Facial Plastic Surgery


The term “platysmalplasty” is often used interchangeably with a neck lift, but really only describes one aspect of the whole neck lift procedure. Platysmaplasty refers to the suspension of the thin flat muscle that is found underneath the skin. This muscle often sags and is responsible for the platysmal bands that many patients find very bothersome. Platysmal bands are the two vertical lines toward the central part of the neck, with one usually more pronounced than the other. These can be seen best when tightening the neck muscles by creating an exaggerated smile and forcefully showing the bottom teeth. This maneuver forces the platysma to contract and make the bands more pronounced. With a platysmaplasty, especially with the deep approach, we free up the muscles and tighten them in the center, creating a nice contoured neckline. This however does not remove extra skin. Mild skin laxity can be addressed by adding skin tightening procedures such as necktite, while large amounts of laxity require either an extended neck lift, or a direct neck lift.

Extended Neck Lift

The extended neck lift procedure is used to rejuvenate the neck by tightening the platysma in the middle as well as the sides of the neck, removing any excess fat, and also removing extra skin from behind the ears. This procedure requires a platysmaplasty first, which tightens the muscle in the central neck. Another incision is then made starting just in front of the ear lobe (hidden in a crease), then extending behind the ear and down along the hairline, similar to the lower portion of a facelift. This second incision is performed on each side allowing for further tightening of the platysma muscle underneath the jawline and also removing any extra skin.

Direct Neck Lift

The direct neck lift offers an option for a comprehensive neck rejuvenation without incision around the ears. This is for individuals that require a platysmaplasty but also have a significant amount of loose skin in the central neck. The excess skin is excised by making an incision in the center of the neck, thus removing the excess skin “directly” from the center of the neck, rather than trying to conceal the incisions around the ears. This offers the benefit of a faster procedure with fewer incisions and less surgical area, however the downside of an incision in the middle of the neck. The incision typically heals very well, however, it is best for patients that are not prone to poor healing or keloid scars. While the direct neck is a very satisfying procedure and a great option for many patients, it is first important to have a very clear conversation with your surgeon regarding expectations for healing and visibility of the scar. Our most common patients for a direct neck are men with an isolated concern of neck laxity.

What’s the first step?

If you’re interested in getting a neck lift in Miami with Dr. Z, reviewing the contents of this page is a great first step as it will help you understand the essentials of the neck lift procedure and to see if it is the right choice for you. The next step is to set up a consultation with Dr. Z. For those that are reasonably close (within 1.5 hours), an in-person consultation is strongly encouraged as it allows Dr. Z to examine the neck and deeper structures through touch. For those out-of-state or from distant parts of Florida, a virtual consultation can be arranged.

The Consultation is a very important step in the process. Dr. Z listens to each patient very carefully in order to understand their unique aesthetic goals and concerns. He then evaluates the appearance of the neck and determines the underlying issues. Based on this discussion and examination, Dr. Z is able to provide a personalized recommendation and treatment plan for each patient. In some cases, one treatment (like a neck lift) is the recommended approach, while in other cases alternative or additional treatments may be suggested. Dr. Z prides himself on being open with all his patients, explaining the reasoning for his recommendations, and helping them make the best choice possible.

Once your procedure is booked, we will provide you with instructions that are specific to your procedure and health background. In general, patients are asked to avoid medications, supplements, and foods that increase the risk of bleeding for at least 1 week prior to surgery. Patients are also asked to avoid tanning for at least 1 week prior to surgery.

It is very important, to be honest regarding your health history, including all medical conditions, surgeries, complications with prior surgeries, family history, smoking status, drug use, medications and supplements, presence of cold sore / herpes outbreaks, and other factors that might impact surgery. The pre-operative work-up can range from simple blood tests, to an ekg, to specific medical clearances for those with health issues. Please remember, this is elective cosmetic surgery, safety is of the utmost importance and precautions should be respected.

The Neck Lift Procedure

The neck lift can vary between patients depending on the amount of laxity, underlying anatomy, and patient goals. It can also be performed awake, with sedation, or under general anesthesia. Refer to our page on understanding the differences between awake, sedation, and general anesthesia.

In order to help understand the neck lift procedure, Dr. Z likes to use the analogy of making a bed. The skin is like a thin cover over the bed, while the platysma muscle and fat are the comforter and pillows underneath. This helps illustrate the point that although the skin can result in surface wrinkles and excess at the surface, the shapes and contours of the neck are largely dependent on the deeper structures. Once these deeper structures are smoothed and tucked, the skin can be laid over them and conform to the new shape. In cases where there is mild skin excess and the skin itself has good elasticity, it will contract and conform without the need for additional procedures or skin removal. However, if the skin is unable to contract or has too much excess, some of it must be removed with additional incisions behind the ears.

In its simplest form, the neck lift is a platysmaplasty performed through a small incision (~3 – 4cm) just underneath the chin, where it is camouflaged by the natural crease. The surgery is then performed through this small opening as the skin is elevated from the underlying platysma muscle. This is the layer where we typically store some excess fat that can be removed with liposuction (if needed). The platysma muscle and the two bands (edges of the muscle) are then identified. The deep fat that contributes to fullness of this “under-chin” area is usually found under the platysma muscle (cannot be reached with liposuction), and so it is removed to improve the neck contour. The platysma muscle can then be addressed in a variety of ways. In most cases, Dr. Z prefers a modified platysmaplasty, where the platysma is just simply pulled together, but first carefully elevated, then tightened to the deeper structures. The lower part of the platysma is also cut in order to prevent the bands from reforming lower in the neck. This creates a very nice angulated and contoured neckline. In this case, the skin is simply allowed to heal back down and conform to the new shape.

The extended neck lift is performed in cases where there is a more significant excess of skin. We start off with the platysmaplasty as described above, but then proceed to make incisions around the ears as well. The incision can vary somewhat but generally starts just in front of the ear lobe, then proceeds behind the ear and down along the back hairline. This is just like the bottom portion of a facelift incision. We can then pull back on the outer part of the platysma muscle as well, anchoring it behind the ear and creating even more contour along the neck, especially under the angle of the jawline.

Neck Lift Recovery

Recovery usually takes about 1-2 weeks. Patients wear a simple compression garment for most of the day and night during the first 1 week, then at night only for the second week. Pain varies from mild to moderate over the first several days and is often described more as a tightness rather than sharp pain. Most patients switch to regular Tylenol between days 1 and 3 after surgery. Bruising is expected and resolves in 1 – 2 weeks. Swelling also varies, but most patients resolve to the point of being “socially acceptable” within 1 – 2 weeks. Results continue to improve for several months as less obvious swelling continues to resolve and the tissues continue to heal. Some patients are happy with the results as early as 2 weeks, while others take more time. If planning this procedure before a major event like a wedding or anniversary, we advise scheduling surgery at least 6 weeks prior.

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Hand in hair | neck lift | Dr. Z Facial Plastic Surgery

Why choose Dr. Z?

When looking for a Miami neck lift surgeon, it’s important you feel comfortable with his expertise and personality. Dr. Z is a board-certified facial plastic surgeon, meaning he’s an expert in facial aesthetics. Dr. Z is passionate about his craft and believes that extended training and learning are life-long responsibilities. He prides himself on offering his patients effective and up-to-date procedures that are the most appropriate for their specific needs.

How Much Does Neck Lift Cost in Miami?

The cost of a neck lift in Miami depends on several factors including the type of anesthesia (awake vs. general) and the extent of surgery (basic midline platysmaplasty vs. extended deep neck lift with lateral suspension). Prices will also typically change with time, increasing as most things typically do in the economy. This is one of the reasons we do not post prices online, however, we will be happy to give a price estimate to those that call to inquire.

Our prices are not the lowest, however, we maintain them at a fair value for the level of expertise and care that is provided by our practice. During your consultation with Dr. Z, he’ll be able to provide his recommendations and a tailored cost estimate will be provided.

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Schedule Your Consultation

Many of our Miami patients feel that a neck lift greatly benefits their lives by giving them more self-confidence and a rejuvenated appearance. If you’d like to book a consultation or have any questions about the procedure, please contact us today. We proudly see patients all over the greater Miami metropolitan area, including but not limited to Miami, Fort Lauderdale, and Hollywood. We also treat and welcome out-of-state patients from all over the US. We look forward to beginning this journey with you!

Neck Lift FAQs