Somewhere around the third video call of the day, a lot of people in this area discover their neck. The laptop camera sits low, the light comes from the wrong side, and there’s a fullness under the jaw they never noticed in the bathroom mirror. We hear some version of that story most weeks at The Naderi Center, in Reston and in Chevy Chase.
The short answer: what fixes the area under your jawline depends on which layer is causing the trouble. A small pocket of fat under firm skin can respond to Kybella or, occasionally, neck liposuction. Most necks that bother people are a deeper problem: fullness below the muscle, bands and loose skin. That takes a deep neck lift, usually done together with a deep plane facelift.
What is actually under the jawline?
Four layers are stacked under the jawline. Skin is on top. Under it is a thin layer of fat. Under the fat is the platysma, a sheet of muscle that runs from the collarbone up to the jaw. Below the platysma sit the things most people have never heard of: a deeper pad of fat, the digastric muscles and the submandibular glands. Each layer ages on its own schedule, which is why two people the same age can have completely different necks.
“Patients point at their neck and say ‘this.’ My job is to work out which layer ‘this’ is,” says Dr. Shervin Naderi, a double board-certified facial plastic surgeon. “Fat under the skin is soft and you can pinch it. The fullness you can’t pinch is usually deeper, under the muscle. No injection or device reaches that.”
What is a deep neck lift?
A deep neck lift is surgery that works below the platysma muscle instead of on top of it. Dr. Naderi lifts the muscle and reduces what is making the neck full underneath: the digastric muscles, the submandibular glands and sometimes the deep fat. Once that structural work is done, he sews the two edges of the platysma together down the middle, which surgeons call a corset platysmaplasty.
It’s a different operation from the neck lift of twenty years ago. Back then I did what everyone did: liposuction under the skin, a big skin flap from the jawline down to the lower neck, then tighten the muscle,” Dr. Naderi says. “Today I lift far less skin and do the real work underneath. The contour comes from the structure, so the skin doesn’t have to be pulled to fake it.”
For most patients the deep neck work is paired with a deep plane facelift. The incisions sit in front of and behind the ear, and through them the platysma is pulled sideways, the neck is tightened and the extra skin is removed. Surgery takes 3 to 4 hours under general anesthesia at Prince William Surgery Center in Manassas.
Will neck liposuction alone fix a double chin?
Occasionally. Liposuction only removes the fat sitting right under the skin, so it helps when that fat is the whole problem and the skin over it is firm. It doesn’t take up slack and it can’t reach anything below the muscle. We do perform it, but for a small share of the necks we see.
The procedure is done under general anesthesia and takes about 90 minutes. “I hardly ever remove the fat under the skin anymore. That thin layer is what keeps a neck smooth,” says Dr. Naderi. “Suction it out of a neck with loose skin and you’ve taken out the stuffing and left the pillowcase.”
Does Kybella work for a double chin?
Kybella works for a small pocket of fat under the chin in someone whose skin is still firm. It’s an injectable form of deoxycholic acid, FDA approved in 2015, and the fat it destroys should not return. It does not tighten anything, so don’t expect a neck lift result from it. Injections at our practice are done by physicians only, and that includes Kybella.
It also takes patience. Kybella is done as a series of 3 to 6 sessions spaced 6 to 8 weeks apart, and each visit is quick. The area under the chin swells for the first few days after each session, and the swelling is not subtle, so don’t book it the week of a wedding.
“Anyone who thinks one or two sessions will do it is going to be disappointed,” Dr. Naderi says. “A full series can take the better part of a year. For a small pocket of fat and firm skin it’s a fine choice. For anything more, it’s the wrong tool.”
Who needs a deep neck lift?
A deep neck lift is for a neck that is full under the jaw in a way you can’t pinch, or one with visible muscle bands and loose skin. Good candidates are healthy and don’t smoke. Our neck lift patients cover a wide age range, and anatomy matters more than the birthday.
The face comes into it too. The platysma doesn’t stop at the jawline, and the way to tighten it runs through the same incisions as a deep plane facelift. “A neck lift that ignores the jowls is like repainting half a wall,” says Dr. Naderi. “You’ll see exactly where I stopped.”
Bone matters as well. A small or set-back chin makes any neck look fuller than it is, because the skin has less frame to drape over. When the chin is the weak point, a chin implant can do a lot for the profile, alone or added to the neck surgery.
Neck lift before and after photos
Real patients of The Naderi Center. Individual results vary.
Can Morpheus8 or skin tightening replace surgery?
No. Morpheus8 uses long microneedles and radiofrequency heat to firm the skin, and it’s a good treatment for mild looseness. A course is 3 to 4 sessions with a touch-up about once a year. “It improves tightness. It is nowhere close to a surgical lift,” Dr. Naderi says. “I’d rather you hear that from me before you start.”
How long is deep neck lift recovery?
Most people take about two weeks off work. A deep neck lift is same-day surgery, so you sleep at home that night, and drains usually aren’t needed. For the first 2 weeks you move your face, neck and upper body as one unit and avoid turning your head side to side, which protects the healing tissue. Exercise waits until about one month.
The result keeps improving month after month. “This is a big operation and the road can be bumpy,” says Dr. Naderi. “At one month you’ll look better than you did, but you won’t love it yet. Most people start to love it somewhere between three and six months. That’s normal, and I tell everyone up front.”
Neck liposuction is quicker. Plan on a week off work and a compression wrap for that first week. Hold off on strenuous activity for 2 to 3 weeks, and the swelling has mostly settled at about a month.
Timing is why this topic comes up every October. Thanksgiving falls on November 26 this year, and surgery by mid-November has most patients comfortable in public by the December holidays. Fall is also turtleneck and scarf season, which is the most forgiving recovery wardrobe there is. Nobody on the Metro looks twice.
Who should perform a deep neck lift?
A surgeon who works below the platysma routinely and does nothing but faces. The deep neck is tight quarters. The glands and muscles being reduced sit beside the nerve that moves the lower lip, and judging how much to take is learned over years. Dr. Naderi is double board-certified, has more than 25 years of experience in facial aesthetic surgery and limits his surgical practice to the face, nose and neck.
Where can I get a neck lift near McLean, Bethesda or Washington DC?
Consultations are offered at both offices. The Virginia office is at 1850 Town Center Parkway, Pavillion II, Suite 551, Reston, VA 20190, (703) 481-0002, and it’s the closer office for Great Falls, Vienna and McLean. The Maryland office is at 5454 Wisconsin Ave, Suite 1655, Chevy Chase, MD 20815, (301) 222-2020, which works well for Bethesda, Potomac and Washington DC. Patients from Arlington and Alexandria tend to pick whichever side of the river has less traffic that day.
Dr. Naderi performs your neck lift himself, start to finish. The operation is done at Prince William Surgery Center, where Dr. Naderi has been medical director since 2023, never in the office.
What happens at a neck lift consultation?
You meet with Dr. Naderi from the start. Nobody screens you first. He examines your face and neck together, tells you which layer is the problem and what will fix it, and you leave with a clear plan. “I’d rather you know exactly what you’re getting,” he says. “Then we pick a date.” Look through our neck lift before and after photos, then book your consultation in Reston or Chevy Chase.
Neck lift FAQ
Is a deep neck lift done under general anesthesia?
Yes. At The Naderi Center a deep neck lift is performed under general anesthesia at Prince William Surgery Center, and surgery takes 3 to 4 hours. You go home the same day.
What does a deep neck lift treat that liposuction can’t?
A deep neck lift works below the platysma muscle, where Dr. Naderi can reduce the digastric muscles, the submandibular glands and deep fat. Liposuction only removes fat directly under the skin.
Where are the scars after a neck lift?
When a neck lift is combined with a deep plane facelift, the incisions sit in front of and behind the ear, with a small incision under the chin.
How much time off work do I need after a deep neck lift?
Most people take about two weeks off work. Exercise waits until about one month, and the final result takes about six months.
Is Kybella permanent?
The fat Kybella destroys should not return, although aging and weight changes continue. Kybella does not tighten the neck and takes a series of 3 to 6 sessions.
Is a neck lift done with a facelift?
Usually. For most patients Dr. Naderi combines the deep neck work with a deep plane facelift so the platysma can be tightened and extra skin removed through incisions around the ear.