Deciding whether liposuction alone would suffice to treat a neck or whether a neck lift is needed depends on what components are involved and what the condition of the skin is. Three components contribute to the sagging neck, skin, fat and muscle. We tuck the muscle up on every neck, known as a platysmaplasty. Some necks have a fatty component that needs to be removed with liposuction and if there isn’t much redundant skin and the skin is elastic then you can expect the skin to conform to the new underlying neck anatomy and do nicely. If the patient is older or has considerable redundant skin however, then something may need to be done to reposition the skin as well, a neck lift. At times the decision is straight forward, but in other patients the decision is a little gray. As long as the patient understands that liposuction and platysmaplasty alone may not give perfect results, we may stick with the lesser procedure and reserve the neck lift for if the result is less than expected. I hope this has been helpful. Our before and after gallery can also help you compare your neck with other patients. As always we would be happy to see you in consultation.