Patients who consult for lower facial rejuvenation sometimes arrive with the terms "neck lift" and "facelift" used interchangeably — as if they were different names for the same procedure. They are not. Understanding the distinction helps patients have more productive consultations and arrive with more accurate expectations.
What a Facelift Addresses
A facelift addresses the lower two-thirds of the face: the jowls, the nasolabial folds when caused by tissue descent, the marionette lines, and the angle of the jaw. It works by elevating and repositioning the deep facial tissue layer (the SMAS) and removing the excess skin that results. A facelift incision runs from the temple, in front of and behind the ear, and typically into the hairline behind the ear.
Most well-designed facelift procedures also address the neck to some degree — the incisions extend behind the ear to allow access to the neck, and the lifting of lower facial tissues naturally improves the neck angle. But the extent of neck improvement from a facelift alone depends on the degree of neck laxity present.
What a Neck Lift Addresses
A neck lift is a procedure specifically focused on the neck — excess skin beneath the chin and along the neck, platysmal banding (the vertical cords that appear in the neck with expression or aging), and submental fat. It may involve a small incision beneath the chin (submentoplasty) in addition to incisions behind the ears.
Patients who have significant neck changes — pronounced banding, significant skin excess below the chin, or "turkey wattle" appearance — with relatively well-maintained facial structure may be candidates for an isolated neck lift. This is a smaller procedure than a full facelift, with a shorter recovery, but it does not address jowling or lower facial descent.
When Both Are Needed
For many patients, the most comprehensive and lasting improvement comes from a combined facelift and neck lift — procedures that are naturally complementary and share incisions. Dr. Kapp designs the surgical approach at consultation based on where the patient's changes are most significant and what combination of techniques produces the most balanced result.
The takeaway: if your primary concern is the lower face and jowls, a facelift is the likely recommendation. If your primary concern is the neck specifically, a neck lift may be sufficient. If both areas have changed significantly, a combined approach is most appropriate. Only an examination tells the full story.