Skin has a memory. Understanding this single fact changes everything about how a lasting result is planned.

Skin is elastic by design — it stretches to accommodate movement, and it is meant to spring back. When skin alone is used to hold up sagging deeper tissue, that same elasticity works against the result. Pulled tight over structures it was never designed to support, skin will gradually creep and stretch back out, typically within 18 to 24 months. The jawline softens again, and the scars — placed under far more tension than they should be — widen and become more visible over time.

Dr Vlad ILLIE approaches a neck lift that is genuinely built to last as an exercise in structural engineering, not fabric tailoring. His goal is to reshape the framework underneath — muscle, fat, glands and, in some cases, the position of the tissue against the skeleton itself — so that the skin can simply drape over a new, well-supported contour. No pulling required.

Before any contour can be sculpted, the central neck needs a stable foundation to sit on.

Running beneath the skin of the neck is the platysma — a thin, wide sheet of muscle that stretches from the collarbone up towards the jaw. In youth, it sits smooth and taut. Over time, its two halves separate along the midline and begin to sag, and this is precisely what produces the vertical “turkey neck” bands that so many patients are self-conscious about.

To correct this, Dr ILLIE works through a deeper surgical plane to reach the platysma directly and perform what is known as a midline platysmaplasty. The separated edges of muscle are brought back together and secured with sutures along the centre of the neck — creating what Dr ILLIE often describes to his patients as an internal corset, or an anatomical hammock. This repair does two important things at once: it elevates the floor of the mouth and re-establishes a firm, well-defined line along the jaw. Everything Dr ILLIE builds afterwards relies on this foundation being secure.

Fullness under the chin is rarely just surface fat — and treating it as though it is can leave a heavy, unresolved result.

Standard liposuction addresses only the fat that sits above the platysma muscle, close to the skin. It can help, but for many patients it doesn’t tell the whole story. A meaningful proportion of “double chin” fullness actually sits beneath the muscle layer, alongside structures that standard liposuction never reaches.

This is where Dr Vlad ILLIE’s deep neck technique distinguishes itself. Working beneath the platysma, Dr ILLIE meticulously removes excess subplatysmal fat, addresses the anterior digastric muscles when they are contributing to fullness, and — where relevant — reduces the size of enlarged or drooping submandibular (salivary) glands. Left untreated, an enlarged gland will continue to create a soft, bottom-heavy contour under the jaw, regardless of how tight the skin above it looks. Managing it at the time of surgery is what allows the final result to look clean and resolved, rather than “almost there.”

Why it matters long-term

Skipping this deeper layer is one of the most common reasons patients feel their neck lift results are underwhelming, or that fullness seems to return — the visible skin was addressed, but the structures actually causing the fullness were left untouched.

There is one structure that quietly sets the physical limits of every neck lift — and it has nothing to do with skin or fat.

The hyoid is a small, U-shaped bone that floats in the neck, unattached to any other bone in the body. It acts as the anchor point for the muscles of the neck and floor of the mouth, and its position determines the cervicomental angle — the angle formed where the chin meets the neck, and the single biggest factor in how “sharp” a jawline can ever appear.

The direction a lift moves in matters just as much as how much lifting is done.

Ageing in the face and neck follows gravity — it is a vertical drop. It follows, then, that a correction which genuinely reverses that process also needs to move in a vertical direction. This is a principle Dr Vlad ILLIE builds every neck lift around: when deeper tissue is instead pulled backward, toward the ears, the result can look tight rather than youthful — a flattened, widened appearance that is often what people mean when they describe a facelift as looking “done.”

By repositioning the deep structures vertically, back toward where they naturally sat in youth, Dr ILLIE leaves the surface skin with very little work to do. It can simply be trimmed and closed without tension — which is precisely what allows incisions around the ear to heal as fine, closely camouflaged lines rather than visible, widened scars.

A premium, long-lasting neck lift is never a single, standardised procedure. For Dr Vlad ILLIE, it is a highly individual piece of structural planning — one that considers each patient’s platysma, fat distribution, gland size, and the position of their own hyoid bone, then builds a tailored surgical plan around them. It is this level of detail, rather than any single technique in isolation, that separates a result which relapses within a couple of years from one that continues to look natural for a decade or more.