A deep dive into deep plane neck liposuction
Targeting two layers of fat for a more defined jawline

Some parts of our bodies just seem to show their age sooner. A few you can cover, and others, like the neck, you can't, at least not completely. Turtlenecks and scarves never reach high enough to disguise the subtle and sometimes not-so-subtle sag.

"In most people, the neck is what ages their face more than anything else," said Sara Dickie, MD.

That's because the skin around the neck tends to be thinner and has slightly fewer oil glands than the face. It means less moisture and collagen, which provides structure to the skin, in the neck.

Difficult to define: Where the face ends and the neck begins

For most people, the boundary between the face and neck can be hard to define.

"The neck is everything from the jowl down to the collarbone," said Alan Matarasso, MD, FACS. "That's what we mean by neck. It's commonly called the chin, but it's the neck."

Ultimately, the lower face and neck are intricately related.

"You can't talk about the face without talking about the neck because that is where the jowls are going," said Dr. Dickie. "It's almost always the facial jowl and the middle neck waddle that people are most concerned about."

Limits of nonsurgical neck treatments

Nonsurgical ways to refresh the face include fillers, neuromodulators, peels and energy devices such as lasers. You can use all those treatments on the neck, but the range of results can make it hard to set realistic expectations.

"I would say none of them are awesome," said Dr. Dickie. "These treatments are often hard to set and meet expectations because they can be variable in what they can do for a person."

The skin around the neck often shows signs of aging faster because it is delicate.

"Which is why many people come in happy with their faces," said Dr. Matarasso.

How deep plane neck liposuction works

One way to rejuvenate the neck is with submental (chin) liposuction. It removes fat under the chin, giving the jawline more definition. You've probably heard of a "deep plane" facelift, but "deep plane" neck liposuction can also add more contour to the jawline for some patients.

"What you can do nonsurgically on the neck is very limited, so deep plane neck liposuction is a choice some people can use before doing a neck lift, which is a surgical procedure," said Dr. Matarasso, who pioneered the procedure.

Deep plane neck liposuction removes two layers of fat from under the chin and neck. It removes the fat directly under the skin, called subcutaneous or preplatysmal fat. Then it also eliminates a second, deeper layer of fat under the platysma muscle of the neck called submuscular or subplatysmal fat. That's the "deep plane" fat.

Benefits of deep plane neck liposuction

This procedure can improve the jaw and neck contour in three ways. First, it removes two layers of fat, including the deep fat under the platysma muscle. Secondly, it tightens the platysma muscle so the horizontal neck bands it creates are less visible. Finally, an added radiofrequency treatment can tighten the skin around the jaw for better definition.

"You're taking this concept of neck liposuction to a whole other level of improving the contour of the jowl around the neck," said Dr. Matarasso.

The procedure is considered minimally invasive and takes about 30 to 40 minutes. It can be done with local anesthetic. Scarring is minimal because the liposuction tool, or cannula, used to remove the fat creates a few small holes slightly larger than the diameter of pencil lead in the crease of the neck where it meets the jaw. Recovery takes about a week to 10 days.

Who deep plane neck liposuction is for

Deep plane neck liposuction is a good fit for patients in their 30s or older who want more contouring than chin liposuction alone can provide. This procedure will not fix sagging skin around the jaw and neck. A neck lift, which is a surgical procedure, would more likely be a better fit.

"Somebody who has a lot of looseness of the skin and wants it tightened, that skin will probably need to be cut out with a neck lift," said Dr. Matarasso.

Choosing the right approach

Neck rejuvenation can refresh one of the body's most visible areas. Subtle tweaks can make a dramatic difference in reducing the signs of aging.

"People are nervous about changing their faces," said Dr. Dickie. "Some only want to fix their neck because that's what really shows up to them as aging them way before they're concerned about their face."

Deep plane neck liposuction gives patients another less invasive option to revitalize their appearance.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.