You’ve seen the ads. You’ve heard the promises. “Tighten your jawline without surgery!” “Melt away double chin fat in minutes!” Non-surgical neck treatments like Kybella, CoolSculpting, Morpheus8, and Ultherapy are more popular than ever, marketed as safe, effective, and convenient alternatives to a surgical neck lift.
But what happens when these treatments don’t deliver the desired result? Or when aging continues and a patient finally decides they need surgery?
Groundbreaking new research suggests that these popular procedures may be creating a hidden landscape of scar tissue and fibrosis under the skin, making a future neck lift significantly more complex, less predictable, and potentially riskier.
In a landmark study recently published in the Aesthetic Surgery Journal, Dr. Thomas Gerald O’Daniel and Sarah Patton set out to answer this exact question. The findings are a must-read for anyone considering any cosmetic procedure for their neck.
What the Study Found: A Surgeon’s View Under the Skin
Dr. O’Daniel performed a detailed review of 180 neck lift procedures he performed in 2023. The goal was to see how prior treatments impacted the surgery.
The results were striking:
- 68% of patients had some prior surgical or non-surgical neck treatment—a three-fold increase from just three years ago.
- Intraoperative findings revealed fibrosis, loss of normal tissue planes, rigid muscles, and unpredictable fat distribution.
- 94% of these cases required a complex “deep cervicoplasty” to address damage to structures beneath the muscle, a procedure not always needed in virgin necks.
- Nearly all patients had post-operative contour irregularities due to the destruction of superficial fat.
- Operative time increased in every single case.
- Perhaps most concerningly, 4% of patients failed to disclose their prior non-surgical treatments, which were only discovered once surgery began.
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Dr. O’Daniel discusses the key findings of his published study on how non-surgical treatments impact neck lift surgery.
How Your Favorite Non-Surgical Treatments Change the Anatomy
In his comprehensive study of 180 neck lift procedures, Dr. O’Daniel documented the shocking intraoperative findings in patients who had undergone popular non-surgical treatments:
Kybella (Deoxycholic Acid) – The Fat Destroyer
- Complete obliteration of healthy fat tissue, leaving yellow globules stuck to the skin
- Severe fibrosis that makes safe surgery nearly impossible
- “Cobra deformity” where skin adheres to deep neck structures
- 94% of patients required deep cervicoplasty to address the damage
CoolSculpting – The Tissue Destroyer
- Paradoxical Adipose Hyperplasia (PAH) creating firm, lumpy masses
- Irregular fat distribution making smooth contours impossible
- Destruction of both superficial and deep fat layers
Energy Devices (FaceTite, Morpheus8, Ultherapy) – The Scar Creators
- Widespread scarring and fibrosis throughout multiple tissue layers
- Destruction of the subdermal vascular network increasing skin loss risk
- Platysma muscle damage beyond normal appearance
- Obliteration of natural tissue planes making surgery extremely dangerous
Thread Lifts – The Complication Magnets
- Random suture adherence to tissues creating unpredictable anatomy
- Increased risk of facial nerve injury during removal
- Multifilament suture integration with surrounding fibrosis
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A visual example of the fibrotic, scarred tissue found during surgery on a patient with a history of non-surgical treatments.
The Takeaway: A Message for Patients Considering Neck Treatments
Dr. O’Daniel’s research reveals the devastating consequences that the aesthetic industry doesn’t want you to know:
Surgical Complications Multiply
- 100% of previously treated patients experienced increased operative time
- Nearly 100% developed contour irregularities due to fat destruction
- Significantly increased risk of skin loss and nerve injury
- 94% required deep cervicoplasty instead of standard procedures
The Tissue Destruction is Permanent
“All non-surgical treatment modalities shared certain characteristics, with the most common being the destruction of the supraplatysma fat and creation of severe supraplatysma fibrosis with obliteration of normal tissue planes,” Dr. O’Daniel reports.
Patients Often Don’t Even Know They’re Damaged
Shockingly, 4% of patients failed to disclose their previous non-surgical treatments, only discovered when Dr. O’Daniel found the telltale signs of tissue destruction during surgery.
The Science Behind the Destruction
Dr. O’Daniel’s research exposes the mechanisms by which these “safe” treatments cause lasting damage:
Kybella’s Cytotoxic Reality
- Deoxycholic acid doesn’t just target fat—it’s more toxic to human skin cells than fat cells
- Creates inflammatory cascades that destroy normal tissue architecture
- Causes indiscriminate tissue damage throughout all neck layers
CoolSculpting’s Hidden Consequences
- Triggers delayed inflammatory responses lasting weeks
- Creates septal thickening and fibrosis that permanently alters tissue
- Can affect deep subplatysmal fat, not just superficial layers
Energy Devices’ Thermal Destruction
- Generate temperatures of 55-65°C that denature collagen and destroy tissue
- Create pyroptosis (controlled cell death) throughout treatment areas
Cause vascular proliferation leading to unpredictable healing
Why Traditional Surgery Remains the Gold Standard
Dr. O’Daniel’s research confirms what experienced plastic surgeons have long known: surgical neck lifts remain the gold standard because they:
- Address deeper anatomical structures that non-invasive treatments cannot reach
- Provide predictable, lasting results without destroying healthy tissue
- Allow precise tissue management tailored to each patient’s anatomy
Achieve the three criteria for optimal neck rejuvenation established by Ellenbogen
The Dr. O’Daniel Difference: Expertise Born from Experience
As one of the few surgeons specializing in corrective neck surgery, Dr. O’Daniel sees firsthand what others in the industry prefer to ignore. His practice has become the destination for patients seeking to repair the damage caused by failed non-surgical treatments.
Published Authority
Dr. O’Daniel’s research represents Level 4 therapeutic evidence published in one of plastic surgery’s most prestigious journals. His findings are backed by:
- 180 consecutive procedures providing robust data
- Detailed intraoperative documentation of tissue damage
- Comprehensive analysis of multiple treatment modalities
- Clinical Professor status at University of Louisville
Surgical Innovation
Dr. O’Daniel’s approach to corrective neck surgery includes:
- Deep cervicoplasty techniques to address subplatysmal structures
- Submandibular gland reduction for optimal contour
- Modified surgical strategies to navigate damaged tissue planes
- Advanced safety protocols for high-risk cases
The Wake-Up Call: What This Means for Patients
Dr. O’Daniel’s research serves as a critical warning to patients considering non-surgical neck treatments:
The Marketing vs. Reality
While the industry promotes these treatments as “safe alternatives to surgery,” the research reveals they:
- Create permanent tissue damage that complicates future procedures
- Rarely deliver promised results in ideal candidates
- Often target the wrong tissue layers for the patient’s specific needs
- Generate revenue without addressing underlying anatomical issues
The Hidden Costs
Patients who choose non-surgical treatments first often face:
- Multiple treatment sessions costing thousands of dollars
- Disappointing results requiring eventual surgical correction
- Increased surgical complexity and associated risks
- Compromised final outcomes due to tissue damage
Expert Recommendations: Making Informed Decisions
Based on his groundbreaking research, Dr. O’Daniel recommends:
For Patients Considering Non-Surgical Treatments
- Understand the permanent risks to tissue architecture
- Recognize the limitations of these modalities
- Consider primary surgical intervention for optimal results
- Seek consultation with board-certified plastic surgeons
For Patients with Previous Non-Surgical Treatments
- Full disclosure of all previous treatments during consultation
- Realistic expectations about surgical complexity and outcomes
- Understanding increased risks including skin loss and nerve injury
- Commitment to deep cervicoplasty procedures when necessary
Considering a Neck Lift? Choose a Surgeon with Experience in Complex Revision
The landscape of aesthetic medicine is changing. Surgeons must now be prepared to operate on necks that have been altered by a variety of energy-based and injectable treatments.
Dr. O’Daniel’s research is already influencing surgical practice nationwide. His findings suggest:
- Increased demand for corrective neck procedures
- Evolution of surgical techniques to address treatment-damaged tissue
- Greater patient education about non-surgical treatment risks
- Industry accountability for long-term outcomes
Experience the O’Daniel Standard of Excellence
When you choose Dr. O’Daniel for your neck rejuvenation, you’re selecting:
- The surgeon who wrote the book on corrective neck procedures
- Louisville’s only Clinical Professor specializing in facial plastic surgery
- Published expertise in managing treatment-damaged tissue
- State-of-the-art techniques developed through research and innovation
Don’t Let Marketing Fool You
The aesthetic industry spends billions promoting “quick fixes” that often create more problems than they solve. Dr. O’Daniel’s research proves that when it comes to neck rejuvenation, there are no shortcuts to excellent results.
Schedule Your Expert Consultation
Don’t risk your neck with unproven treatments. Consult with the surgeon whose research is changing how the industry thinks about neck rejuvenation.
Contact Dr. O’Daniel’s Louisville practice to learn how proper surgical technique can deliver the results you deserve, safely and effectively.
→ Explore Neck Lift Options with Dr. O’Daniel
→ Read the Full Study Here
