Troubled by a double chin, “turkey neck” or undefined jawline? A Boston necklift could be the perfect understated solution that achieves the dramatic improvement you’re looking for.

When comparing procedures to give us a more youthful appearance, a necklift may not be the most obvious option that comes to mind. But what goes on below the chin can hold the secret to looking, and feeling, decades younger. And it’s hard to argue with the evidence. Based on 274 recent reviews from people who have had the procedure done, 251 said it was worth it.

But what’s involved with a necklift, does it always involve surgery and how natural are the results?

What is a Boston necklift?

For anyone who feels the upper part of their face is aging well in comparison to the lower (be it a double chin, banding on the neck, sagging jowls, or all three) the necklift can really balance their features.

Also known as a lower rhytidectomy, the necklift is designed to turn back the years by creating a more defined jawline and a slimmer neck with smoother skin.

And the figures suggest it delivers results.

According to the statistics, over 160,000 people had the operation done in 2020 with a 92% satisfaction rate. In fact, one patient said, “I look incomparable with how I looked before surgery….Bottom line: I look very good, much younger, natural.”

What types of surgical methods are used during a necklift?

When researching necklifts that might work for you, it can be difficult to know where to start.

Surgical techniques generally target 3 areas:

  • Excess fat
  • Loose platysma muscles (which as explains, is a band of tissue found in the chest, neck and facial region).
  • And sagging skin

A survey done by the American Society for Dermatologic Surgery indicated that 67% of respondents were bothered by excess fat under the chin or neck.

To improve the definition of the jawline by removing fat, Seattle facial plastic surgeon Dr. William Portuese, says a surgeon has two options.

The chosen procedure depends on whether fat has accumulated above the platysma muscle – in which case liposuction would be used – or both above and below the platysma – which means surgery is required. Most patients require the second solution.

As well as a double chin, loose platysma bands are said to be one of the first signs of aging which, one report claims, is thought to happen as skin sags followed by a loss of muscle tone, creating the proverbial “turkey neck” effect.

This is addressed by a procedure called a “platysmaplasty”, which says tightens the underlying neck muscles to rejuvenate the neck area. This process doesn’t remove excess skin or fat.

Instead, unwanted, sagging skin that’s come about by a loss of collagen and elastin or from weight loss, is addressed by a cervicoplasty – which targets the area underneath the chin and neck area. A cervicoplasty, however, doesn’t tighten the neck muscles.

There are other variations to the main surgical techniques.

Deep Necklift

A deep necklift addresses muscles deeper than the first couple of layers so can result in a more naturally youthful result.

Short-scar Necklift or Mini/Micro Necklift

Surgeons may also use a short scar necklift or mini or micro necklift for those with more moderate signs of aging, where smaller incisions are made under the chin or near to the temples to change the neck structure below the skin.

Hyo Necklift

A relatively new development is the Hyo necklift which involves stitching the band of tissue in the neck muscles towards the bone at the root of the tongue and then to the skin. Results show this creates an improvement in the area under the chin and may be less invasive than a full necklift.

Are there any minimally invasive, natural or instant solutions?

Talking about less invasive, if we want to turn back the years, is it really necessary to have surgery?

There are a number of treatments available that address fat, loose skin and banding which don’t require a surgical procedure and usually result in less downtime than having an operation.

Thread Necklift

The thread necklift can produce results for moderate issues. The surgeon uses absorbable sutures to reduce sagging which, according to, also stimulates the production of collagen to produce healthier, firmer skin.

Nefertiti Lift

Alternatively, injectables like botulinum toxin, are used in the so-called “Nefertiti lift”. The injections prevent muscle contraction, which can cause wrinkles and other signs of aging, and can lessen existing lines, smooth dimpled skin and reduce sagging.

Other Non-Surgical Techniques

Other non-surgical techniques include ultrasound skin tightening, where the skin is heated to encourage collagen production, and radio frequency (RF) treatments, which act in a similar way.

Fat Treatment

For fat treatment, some favour deoxycholic acid (also known as Kybella), which, as John Hopkins Medicine explains, is a substance that’s injected under the chin to melt fat that the body then reabsorbs.

Fat Reduction

Fat reduction can also be instigated by freezing and destroying fat cells (by techniques like CoolSculpting) which according to research, can cause a 20-80% reduction of fat following one procedure. This may be to the lower end when performed on the under chin area.

Even less invasive solutions include using instant neck tape to pull back sagging skin as well as good old-fashioned facial exercises that may go some way to preventing further signs of aging.

How long does a Boston necklift take?

But for many people with advancing signs of aging, an operation is the most effective way to address their issues.

The Aesthetic Society says that surgical necklift procedures can range from one hour to three hours or more, depending on the complexity of the surgery. And usually, it’s performed as an outpatient procedure with patients going home the same day.

Who makes a suitable candidate for a necklift?

Some surgeons suggest that the best time to get necklift surgery is before the age of 45 – 55 because most of the aging effects that lead to turkey neck occur during that period. However, healthy people in their seventies have surgery too.

Generally, the ideal candidate for a lower rhytidectomy is someone who is bothered about excess fat under their chin, sagging skin below the jawline and/or suffers from the turkey neck effect.

They should be healthy and a non-smoker with relatively good skin tone and have realistic expectations about what their surgery can achieve.

Can a necklift be combined with other surgeries?

For patients who’d like to refresh and rejuvenate more of their appearance, a necklift is commonly combined with other procedures.

Facelift procedures address deep mouth creases, loose skin on the cheeks, and sagging jowls by tightening muscles, redistributing fat, and removing excess skin. Treating the face and neck at the same time means the patient should receive a more seamless look from the cheeks down to the collarbone.

You can read our blogs on “A Patient’s Guide To a Facelift Procedure in Boston and “How Much Does A Boston Facelift Cost

For signs of aging above the eyes, a brow lift can also be performed to refresh a patient’s look by raising the skin upward and creating a smooth and youthful-looking forehead.

Blepharoplasty, or eyelid surgery, is another option. This procedure focuses on addressing puffy skin and fat around the eyes and tightening loose skin on the upper and lower lids to create a more youthful appearance.

A necklift may also be typically performed alongside a chin implant. As realself, reports, this is where a sculpted piece of material is inserted into the chin to increase its size and improve the definition of the jawline.

What are the benefits to a Boston necklift and how long will they last?

The impact of a necklift procedure can be seen straight away. One patient reports, “I am only 3.5 days post op and can already see significant improvements”.

And by maintaining a healthy lifestyle after surgery, patients could prolong the results by slowing down the future signs of aging.  In fact, as Dr Zoran Potparic says, a well-performed necklift should last for 10 to 15 years. 

In contrast, non-surgical rejuvenation treatments can’t achieve the result.  The American Board of Cosmetic Surgery outlines that some skin tightening procedures don’t show immediate results, may require multiple visits to the provider and produce an overall effect that lasts around a year.

But they are definitely worth consideration by some patients with moderate issues. states that they may help delay the time at which a necklift becomes appropriate.

Can necklift surgery go wrong?

As with any operation, there are risks to having an anaesthetic and undergoing surgery, but with regards to a necklift in particular, some patients complain of a feeling of tightness in their neck at first. If this doesn’t relax over time, some surgeons recommend ultrasound treatments or a relaxing of sutures if these have been used.

Others may notice an asymmetry that may be attributed to the recovery process or could require corrective surgery.

Patients are always advised to refer back to their board-certified surgeon for advice if they’re worried about their results.

How much does a Boston necklift cost?

Neck lift prices found on the Internet vary widely. Much depends on whether the chosen operation is targeting fat, skin, or muscle – or all three at the same time.

At the lower end of the scale, a neck lift can cost a few thousand dollars with prices reaching around $15,500 towards the higher end.  Fees are dependent on factors like the surgeon’s experience, the locality of their clinic, any additional facility costs, the level of anaesthesia and medication.

But the final price tag also depends on any other surgeries that may be combined alongside. For instance, different approaches for a chin implant may cost between $1,200 and $12,700, according to the American Board of Cosmetic Surgery.

What does recovery from a Boston necklift surgery involve?

Downtime from a necklift depends on the individual but may be between 1 – 2 weeks. Immediately after surgery, patients can expect to experience swelling and bruising and excess blood or fluid could call for the use of pressure dressings or drains.

But many recover quickly. One patient reports, “I felt no pain and after 9 days out, although still very bruised and swollen, I feel like a new woman!”.

Patients should be back to normal activities after a month with the last signs of surgery disappearing within a year.


The good news is there are a wide variety of necklift techniques available to suit an individual’s needs as well as their pockets.

But as with all plastic surgery, it is vital that you carry out thorough research, ensuring your surgeon is board certified and well qualified in the surgery that’s right for you. Make sure you compare consultations and are satisfied with the responses you get to all of your questions, including the type of aftercare you can expect to receive.

But rest assured. In the right hands, your surgery can achieve a subtly refreshed and youthful look – without anyone ever knowing how you’ve done it.


Please note: All materials on the Site, such as text, treatments, outcomes, photographs and images and any other material provided on the Site are for information purposes only and are not a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding treatments. Never disregard professional medical advice or delay in seeking it because of something you have read on this Site.
Though the content of this blog has been carefully prepared, the author of this content is not a medical doctor and the content has not been reviewed by a Board-Certified Plastic Surgeon. 
Unless specifically stated, patients referred to in this blog have not received a Boston Necklift by Dr Mark Markarian. This blog does not endorse the work of any doctors or surgeons mentioned. Stories relating to patients’ personal experiences of the Necklift procedure should be treated as anecdotal only.
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