Why does the neck age before the face?
Many patients arrive at consultation having invested years —and a good deal of money— in their face, and still do not recognise themselves in profile photographs. The reason is that the neck ages on its own terms and by its own mechanisms, and no facial treatment reaches it.
What is lost in the neck is three things at once, and confusing them is why so many treatments disappoint:
- The vertical bands —those two cords that show when speaking or tensing the neck— are muscle: the edges of the platysma, which separate along the midline over the years and become visible. No external energy device, no cream and no thread restores a separated muscle. It is sutured.
- The double chin is submental fat, and sometimes also deep fat beneath the muscle, which no diet reaches selectively.
- The "turkey neck" —hanging skin— is excess skin that has lost its elasticity. When skin is not going to retract, no technology will make it retract: it has to be removed.
What the operating room solves — and what it does not
An honest answer is needed here, because this is where the most money is wasted on treatments that were never going to work. If your problem is fat only and your skin still has good elasticity, the solution may be smaller than a lift: submental liposuction, or even an endolift, with no major surgery. We will tell you that at the consultation rather than sell you an operation you do not need.
But if platysmal bands are already marked and skin is hanging, external energy will not correct them, however many sessions accumulate — and that has to be said too. A separated muscle is sutured and excess skin is removed. That is surgery, and there is no shortcut.
Techniques used by Dr. Arístides Arellano
The plan is built layer by layer —fat, muscle, skin— and only what is actually altered in your case is treated:
- Platysmaplasty (correcting the bands): through a small incision under the chin, the edges of the platysma are reached and sutured back together in the midline (corset platysmaplasty), rebuilding the muscular "hammock" that supports the neck. It is the manoeuvre that erases the vertical bands — and the one no non-surgical treatment can imitate.
- Submental lipectomy / submental liposuction: removal of the fat beneath the chin —superficial and, where appropriate, the subplatysmal fat beneath the muscle, which liposuction alone cannot reach. It is what restores the cervicomental angle: the crisp line between chin and neck that the eye reads as youth.
- Cervicofacial lift: when excess skin is also present, it is removed and redraped through incisions around the ear, extended into the retroauricular area and the hairline, where they remain hidden.
- SMAS repositioning: the facelift and the neck lift share the same deep plane, which is why they are frequently performed together: treating only the neck in a patient with evident facial laxity leaves an incongruent result — and the reverse is equally true.
- Association with chin surgery: an under-projected chin makes the neck look worse than it is, because there is no bone to hold the angle. In those cases, augmenting the chin improves the neck more than any manoeuvre on the neck itself.
How is it performed?
It is performed under general anaesthesia or deep sedation in a hospital operating room. It lasts approximately 2 to 4 hours if only the neck is treated, and 3 to 5 hours when combined with a facelift. It usually requires one night of observation. A cervicomental compression band is applied at the end and worn as directed during the first weeks.
All surgery carries risk and requires a prior medical assessment. Results may vary according to each patient, their anatomy and their individual healing process.
Who is a good candidate?
- Visible vertical bands in the neck when speaking or tensing it — the sign that the platysma has already separated.
- Loss of the angle between chin and neck, with a profile that reads as heavy or blurred.
- Hanging neck skin, with loss of elasticity.
- Good general health and not smoking —or stopping with the lead time indicated: tobacco compromises the circulation of the neck skin flaps, an area particularly sensitive to it.
- Realistic expectations: a neck lift repositions muscle and removes skin and fat; it does not change the texture or the sun damage of the décolletage skin — that is treated with laser.
Recommended post-surgical treatments
Dr. Arístides may recommend manual lymphatic drainage and hyperbaric chamber sessions to reduce swelling and bruising in the area, and later treatment of the retroauricular scars. See the full guide: Post-surgical recovery and care.
Before and after
Most patients want to see before-and-after photographs before deciding. Out of respect for each person’s privacy, Dr. Arístides Arellano shows real cases —always with documented consent— during your in-person consultation, where you can review results from patients with a starting point similar to yours. Results may vary from patient to patient.
Approximate price
The cervicofacial lift is quoted against the rhytidectomy reference: $80,000 MXN. Approximate price — the definitive cost is set at your private consultation with Dr. Arístides Arellano. The final cost depends on the extent —neck alone, or face and neck in the same operation—, on whether submental liposuction or chin surgery is associated, and on hospital and anaesthetist fees. See the price list.
About Dr. Arístides Arellano
Dr. Arístides Arellano is a plastic surgeon holding a specialty licence: he practises under a Mexican medical licence (D.G.P. 1125959) and a specialty licence in Plastic & Reconstructive Surgery (0002008), both issued by the Directorate General of Professions (DGP), which reissued his certificate of professional standing in 2025. His career began before Mexico’s present-day specialty-board system existed: he belongs to the founding generation of plastic surgery in Puebla, the second generation of a surgical tradition started in 1971 by Dr. Francisco Arellano Ocampo. Trust is verified, not promised: both licences are public and anyone can look them up in the DGP’s National Registry of Professionals.
Related patient guide
If you are assessing the whole face: Facelift (rhytidectomy) — the page that explains the deep plane (SMAS) and why a well-executed lift does not stretch the skin.
Documented training in facelift and facial rejuvenation
The face and neck lift is the facial operation where accumulated experience weighs most. Dr. Arístides Arellano is a specialist in Plastic & Reconstructive Surgery authorised by the DGP since 1990, and he has lectured on facelift surgery at international congresses:
- Speaker: facelift and skin resurfacing in the same procedure — XXIX Congreso Argentino de Cirugía Plástica (IPRAS) · 1999
- Article: Fat grafting and rhytidectomy — Cirugía Plástica Ibero-Latinoamericana, Vol. XIV Núm. 4, 1988 His own publication: fat grafting combined with rhytidectomy — the principle modern facelift surgery was built on.
- Course: facial aesthetics — XXVI Congresso Brasileiro de Cirurgia Plástica · Blumenau, 1989
- Facial surgery course — Sociedade Brasileira de Cirurgia Plástica · Río de Janeiro
- Observership at the Ivo Pitanguy Clinic — letter from Prof. Pitanguy — PUC Río de Janeiro / Instituto Carlos Chagas · 7–9 de agosto de 1989
Trust is verified, not promised. All 210 scanned documents —degree, licences, diplomas, publications and certificates, from 1977 to 2025— are open in Dr. Arístides Arellano’s credential archive, alongside an explanation of the difference between a specialty licence and a board certification.
Recovery · step by step
- Week 1Cervicomental compression band; swelling and bruising. Rest with the head elevated.
- Week 2Suture removal; most patients already feel presentable.
- Weeks 3–4Gradual return to activity; strain and abrupt neck movements are avoided.
- Months 2–6Scars mature and the neck contour settles.
Frequently asked questions
How much does a neck lift cost in Puebla?
The cervicofacial lift is quoted against the rhytidectomy reference, approximately $80,000 MXN. The exact amount depends on the extent —neck alone, or face and neck in the same operation—, on whether submental liposuction or chin surgery is associated, and on hospital and anaesthetist fees. It is confirmed at your in-person consultation.
What are neck bands and why do treatments not remove them?
They are the edges of the platysma muscle, which separate along the midline over the years and become visible as two vertical cords when speaking or tensing the neck. They are muscle, not skin or fat. No external energy device, no cream and no thread rejoins a separated muscle: they are corrected by suturing the edges of the platysma back together in the midline, in an operating room.
Do I need a neck lift or is submental liposuction enough?
It depends which layer is altered. If the problem is fat beneath the chin only and your skin retains good elasticity, submental liposuction can resolve it without major surgery, and we will tell you so at the consultation. If platysmal bands are already marked or skin is hanging, liposuction will not correct them: the separated muscle is sutured and the excess skin removed.
What is the cervicomental angle?
It is the line between chin and neck: the crisper and more defined it is, the younger the profile reads. It is lost through accumulation of submental fat, separation of the platysma and skin laxity. Restoring it is the central goal of neck surgery.
Can the neck be operated on alone, without a facelift?
Yes, when laxity is confined to the neck and the face shows no significant descent. But the facelift and the neck lift share the same deep plane, and in a patient with evident facial laxity, operating on the neck alone leaves an incongruent result. The assessment defines the extent appropriate to your case.
Does a small chin make the neck look worse?
Yes. An under-projected chin makes the neck look worse than it is, because there is no bone to hold the angle between chin and neck. In those cases, augmenting the chin with a mentoplasty improves the profile more than any manoeuvre on the neck itself, and the two are frequently combined.
Where are the neck-lift scars?
Platysmaplasty requires a small incision under the chin, concealed in the natural shadow of the area. When skin is also removed, the incisions extend around the ear into the retroauricular area and the hairline, where they remain hidden. All of them mature and fade over time.
Does a neck lift improve the skin of the décolletage?
No. Surgery repositions muscle and removes skin and fat, but it does not change the texture, pigmentation or sun damage of the skin. That is treated with laser, which can be done after surgery as a complementary treatment.
Every case is different. Discuss yours in a personal consultation.
Book a consultation on WhatsAppEvery figure published on this site is approximate and is not a quote. Any procedure or treatment first requires a private assessment consultation with Dr. Arístides Arellano —$800 MXN, charged separately— and it is at that consultation that the definitive cost of your case is determined.
Educational content; it does not replace a medical consultation. Results may vary from person to person.