In the past decade, nonsurgical treatments have become increasingly popular for tightening and contouring the neck. From Kybella and CoolSculpting to thread lifts and radiofrequency devices, these treatments promise markedly visible improvements with minimal downtime. Yet many patients who later seek a surgical neck lift after fading results discover that these prior procedures have created new challenges for achieving a smooth, natural look.
At O’Daniel Studios Plastic Surgery, Dr. O’Daniel frequently sees patients who have undergone one or more nonsurgical treatments to the neck and jawline before coming in for surgical correction. In the Aesthetic Surgery Journal, Dr. O’Daniel examined how these nonsurgical treatments affect surgical complexity, tissue quality, and long-term outcomes. The findings provide valuable insight into how nonsurgical interventions can permanently alter the neck’s anatomy and what patients should know before choosing them.
How Nonsurgical Treatments Affect the Neck
Nonsurgical devices and injections typically target the upper layers of the neck, including the skin and superficial fat. These treatments can produce temporary tightening or reduction in fullness, but they do not address the deeper structures that shape the neck’s true contour. The platysma muscle, fascia, and submandibular glands play key roles in defining neck structure and firmness. When these deeper layers remain untreated, surface-level tightening can create imbalance and even distort the natural anatomy.
Heat-based and fat-dissolving treatments can also have unintended effects on tissue quality. Procedures such as Kybella, CoolSculpting, FaceTite, Morpheus, SmartLipo, and Ultherapy may lead to fibrosis, scarring, or fat loss that compromise the natural tissue planes. These changes can make surgical dissection more challenging and may limit the degree of refinement possible during a neck lift.
What Dr. O’Daniel’s Study Revealed
Dr. O’Daniel’s journal analyzed 180 of his neck lift procedures performed in 2023, with more than two-thirds having a prior history of nonsurgical treatments. Across these cases, he observed fibrosis, rigidity of the platysma and deep fascia, and unpredictable fat distribution, which are all signs of prior tissue disruption.
Because of these changes, a deep neck lift was required in nearly every case to achieve balanced, natural contours. This approach involves working beneath the platysma to sculpt and reposition deeper structures such as the subplatysmal fat and submandibular glands. Although no major complications occurred, procedures in previously treated patients were more complex and required greater precision due to scarring and altered anatomy.
These findings underscore the long-term effects of nonsurgical procedures and the importance of selecting treatments based on a clear understanding of how they interact with facial and neck anatomy.
What This Means for Patients
While nonsurgical options are appealing for their convenience, it’s important to recognize their limitations. Treatments that deliver heat or energy into the tissue can fuse layers together, harden fascia, and destroy supportive fat that helps maintain youthful softness. Once those tissues are altered, they cannot be restored to their natural state, even with surgery.
Subcutaneous fat, the thin layer of cushioning just beneath the skin, is often misunderstood. Many treatments target it as the source of fullness or sagging, when in fact it contributes to smooth, youthful contours. Over-treating this layer can lead to contour irregularities, hollowing, or accelerated aging.
For patients considering surgery after previous treatments, a thorough consultation is essential. Being honest about past procedures allows the surgeon to anticipate tissue changes, plan accordingly, and set realistic expectations for the outcome.
The Value of Surgical Expertise
Deep neck lift surgery remains the most effective and reliable method for restoring definition and balance to the neck and jawline. However, when nonsurgical procedures have altered the anatomy, a higher level of surgical experience is required. Dr. O’Daniel’s extensive expertise in facial and neck anatomy allows him to identify and navigate these tissue changes, restoring harmony to the structures that define the neck’s natural form.
At O’Daniel Studios, each surgical plan is individualized to the patient’s anatomy, history, and goals. By addressing both the superficial and deep layers of the neck, Dr. O’Daniel’s approach ensures results that look refined, natural, and long-lasting, even in complex revision cases.
Making Informed Treatment Choices
The rapid growth of aesthetic technology has introduced many devices that promise surgical-like results without surgery. However, these procedures are not interchangeable with surgery and are not appropriate for every patient. Understanding which tissues each treatment targets and the potential long-term effects on those tissues is key to protecting the integrity of the face and neck.
Patients considering nonsurgical procedures should seek a consultation with a board-certified plastic surgeon who understands both nonsurgical and surgical techniques. This ensures that every treatment choice supports long-term goals rather than creating complications for future correction.
The Takeaway
Nonsurgical treatments can have a place in aesthetic care, but they are not a replacement for surgery when deeper structures are involved. Once energy-based or fat-dissolving procedures alter tissue, the changes are often permanent and can make later surgery more complex.
For patients seeking lasting, natural improvement, understanding the science behind each treatment and choosing an experienced, anatomy-focused surgeon makes all the difference. The best outcomes come from informed decisions, thoughtful planning, and a comprehensive understanding of how each layer of the neck contributes to a balanced, youthful appearance.
