VASER (Ultrasound-Assisted) Neck Liposuction (suction assisted lipectomy)
VASER (ultrasound-assisted liposuction) of the neck removes excess fat from under the chin and the upper neck. The fat it removes sits above the platysma muscle, in the layer just beneath the skin. Ultrasound energy is used to loosen the fat first, and the fat is then removed by suction through small incisions hidden under the chin and behind the ears.
It is a procedure with a narrow indication. It is suited to one specific problem: fullness under the chin caused by excess fat above the muscle, in a neck where the skin still has good tone.
It is just as important to understand what this procedure does not do:
- It does not remove or tighten loose skin. If the skin has lost its elasticity, removing fat beneath it can make laxity more visible, not less.
- It does not treat platysmal banding, the vertical bands that appear when the edges of the platysma muscle separate.
- It does not treat fullness that sits beneath the platysma muscle. That deeper layer needs a different operation.
- It does not change skin texture or fine lines.
Changes in the neck with age are a normal part of ageing, and fat under the chin is also common earlier in adult life as an inherited feature. Liposuction (suction assisted lipectomy) removes fat cells from the treated area, but it does not stop the ageing process. The skin and muscle of the neck continue to change over time, and body weight changes can alter the result.
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What VASER (ultrasound-assisted liposuction) of the neck is suited to
The right candidate for this procedure has a specific combination of findings. At assessment, I am looking for:
- Fullness under the chin caused by fat above the platysma muscle
- Skin with good tone and elasticity, so it can settle back smoothly once the fat is removed
- No significant platysmal banding
- No significant fullness in the layer beneath the muscle
- Stable body weight
That combination is more common earlier in adult life, and in patients where fullness under the chin runs in the family rather than being a change of ageing. In an older neck, loose skin and muscle banding are usually part of the picture, and liposuction (suction assisted lipectomy) alone is not the right operation for those changes.
Where the assessment shows something different, I say so and recommend the operation that fits:
- Loose skin or muscle banding is treated with a neck lift (cervicoplasty), often including platysmaplasty. I explain this on my neck lift (cervicoplasty) page and my platysmaplasty page.
- Fullness beneath the platysma muscle is treated with a deep neck lift (cervicoplasty). More detail is on my deep neck lift (cervicoplasty) page.
VASER (ultrasound-assisted liposuction) is also used as one component of a larger neck operation, where removing fat above the muscle is genuinely part of what an individual neck needs. Whether that applies to you is decided at consultation.
Some patients with minor fullness are better suited to non-surgical measures, or to no treatment at all. I discuss those options at consultation where they are relevant.
How I perform VASER (ultrasound-assisted liposuction) of the neck
I perform this procedure under general anaesthesia at Maitland Private Hospital.
The steps are straightforward to describe:
- Small incisions are made in the crease under the chin and, where needed, behind the ears
- The area is first infiltrated with fluid containing local anaesthetic, which also reduces bleeding
- A fine ultrasound probe is passed through the incisions. The ultrasound energy loosens the fat in the layer above the platysma muscle
- The loosened fat is then removed by suction through a fine cannula
- The incisions are closed with fine sutures and a supportive chin garment is applied
How much fat is removed, and from exactly where, is planned from the assessment and the standardised photographs taken at consultation. The aim is an even layer of fat left behind so the skin settles smoothly, rather than removing as much fat as possible.
When VASER (ultrasound-assisted liposuction) is performed as a component of a neck lift (cervicoplasty) or deep neck lift (cervicoplasty), it is done in the same operation, under the one anaesthetic.
My approach
Everything starts with assessment. Before recommending any neck procedure, I examine the skin, the platysma muscle, and the fat in both layers of the neck, and take standardised clinical photographs. With liposuction (suction assisted lipectomy) in particular, the skin assessment is the deciding factor. If the skin does not have the tone to settle after fat is removed, I will not recommend this procedure.
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About Dr Beldholm
I have spent more than 15 years operating on the face and neck. That experience matters with a procedure like this one, because the skill is not in the liposuction (suction assisted lipectomy) itself. It is in judging which necks it suits, and recognising when a different operation is the right recommendation.
I am a Fellow of the Royal Australasian College of Surgeons (FRACS) and work as a Specialist Surgeon. My practice covers the full range of neck surgery, from liposuction (suction assisted lipectomy) alone through platysmaplasty and neck lift (cervicoplasty) to deep neck lift (cervicoplasty), which means my recommendation is based on what your neck needs rather than on the one procedure I offer. Where non-surgical measures are the better fit, I discuss those at consultation too.
I operate at Maitland Private Hospital in the Hunter Valley, a fully accredited private hospital with 24-hour medical cover, and I review my patients personally throughout recovery.
Your pathway
GP referral
A referral from your GP is required before any consultation.
Consultation
Your first consultation runs for about an hour. It covers your health history, examination of your neck including skin tone, the platysma muscle, and both fat layers, standardised clinical photography, and a frank discussion of what this procedure can and cannot do for you. If the assessment points to a different operation, I will tell you so at this visit.
Second consultation
A second consultation is required before surgery and is free of charge. It gives you time to consider the information and come back with questions.
Quote
You receive a written quote for my surgical fee. Quotes for the hospital and the anaesthetist are separate, and my patient coordinator organises these for you. A supportive chin garment is provided by the practice, and all post-operative follow-up with me is included at no additional cost.
Surgery
The procedure is performed under general anaesthesia at Maitland Private Hospital.
Follow-up
Follow-up is intensive for the first 2 weeks, with regular reviews for dressing checks and wound care. After that, I see you at 4 weeks, 3 months, 6 months, and 12 months.
Recovery in brief
Recovery from neck liposuction (suction assisted lipectomy) is generally shorter than recovery from a neck lift (cervicoplasty), but it is still surgical recovery and it takes time.
- Swelling and bruising under the chin and in the upper neck are expected in the first 1 to 2 weeks
- The supportive chin garment is worn as directed in the early weeks to help the skin settle
- The treated area is often firm and numb for a period. This settles gradually over weeks to months
- Most patients take about a week off work, depending on the work they do
- Return to exercise is staged, and I guide this at your reviews
- The final shape of the neck takes months to show, because the deeper swelling resolves slowly
Recovery varies between patients. I cover the full week-by-week detail in my article on neck lift (cervicoplasty) recovery, which includes liposuction (suction assisted lipectomy) of the neck.
Risks
Liposuction (suction assisted lipectomy) of the neck is a smaller procedure than a neck lift (cervicoplasty), but it is still a significant procedure performed under general anaesthesia, and it carries real risks. I go through these with you in detail at consultation. They include:
- Bleeding and haematoma (a collection of blood under the skin)
- Seroma (a collection of fluid under the skin)
- Skin burns from the ultrasound energy, a recognised risk specific to ultrasound-assisted techniques
- Contour irregularity, including lumpiness, unevenness, or over-hollowing of the treated area
- Skin laxity becoming more visible after fat is removed, particularly if skin tone was borderline
- Injury to the marginal mandibular nerve, which can cause temporary or, rarely, permanent weakness of the lower lip
- Numbness or altered sensation in the treated area, which usually settles but can persist
- Prolonged swelling and firmness
- Asymmetry
- Infection
- Scarring at the incision sites, which are small but permanent
- Risks of general anaesthesia
- The possibility of revision surgery
Results vary between patients, and no outcome can be guaranteed. I cover neck surgery complications in full in my article on neck lift (cervicoplasty) risks and complications.
Is VASER (ultrasound-assisted liposuction) of the neck right for you?
That depends on one question: is excess fat above the platysma muscle, under skin with good tone, actually what is causing the fullness in your neck? If it is, this procedure suits you well. If loose skin, muscle banding, or deeper fullness are part of the picture, a different operation will serve you better, and I will tell you which one.
The only way to answer that question is examination. At consultation I assess your neck layer by layer and give you an honest recommendation, whether that is this procedure, a different one, non-surgical measures, or no treatment at all.