The Three Problems Under the Chin
People say “my neck” and mean one of three different things, which need different answers.
Leo J. Urbinelli, MD, Board Certified Plastic Surgeon *Top Plastic Surgeon in CNY* Bringing his expertise from NYC and Los Angeles back home to Upstate NY
The neck is where age shows first and where makeup cannot help. A neck lift addresses loose skin beneath the chin, the vertical bands that appear when you turn your head, and fullness that blurs the jawline. It is frequently combined with a facelift. Book a consultation.
Dr. Leo J. Urbinelli, a skilled neck lift surgeon in Syracuse, New York, does not just remove loose skin and move on.The neck often changes because of deeper structure, not only surface looseness. So the plan has to be more thoughtful.
At Premier Aesthetics, treatment is built around your face, your neck, and your goals. Dr. Urbinelli uses a careful approach that aims to improve contour while still keeping the result believable. That part matters. People should notice that you look fresher. They should not guess why.
A neck lift may help with:
Some patients come in saying they want the neck fixed. Then it turns out the jawline needs attention, too. That is common. The neck and lower face usually work as one unit.
People say “my neck” and mean one of three different things, which need different answers.
Loose skin. Skin that has lost elasticity and hangs. Only surgery removes it. Devices that promise tightening do little once skin has genuinely stretched.
Platysmal bands. The vertical cords that stand out when you tense or turn. These are the edges of a thin sheet muscle that has separated in the midline. They are tightened surgically, and no injectable repairs that separation.
Submental fullness. Fat beneath the chin, which may sit above or below the muscle. Fat above the muscle can be removed with liposuction. Fat below it requires an open approach.
Most necks involve more than one of the three, which is why an examination matters more than a photograph.
Someone whose jawline has softened, who is conscious of the profile in photographs, and who understands that this corrects contour rather than skin quality. Weight should be stable, because fat returning under the chin will undo the shape. Smokers stop in advance for the same vascular reasons that apply to a facelift.
A short neck with a low hyoid bone limits how sharp the angle under the chin can be made. That anatomy is explained at the consultation rather than discovered afterward, because it is the commonest reason a result falls short of what someone imagined.
A small incision under the chin gives access to the muscle, which is tightened across the midline. Where skin needs removing, incisions behind the ear allow it to be redraped. A combined facelift and neck lift shares the incisions around the ear and one recovery, adding only the small incision under the chin, which is the main argument for doing them together rather than a year apart.
Operating time, anesthesia and facility fees are quoted after the examination. See financing options.
A supportive garment is worn initially. Swelling and tightness are expected for the first week or two, and most people are comfortable in public at around two weeks. The contour refines for several months as swelling resolves. Numbness under the chin is common early and usually improves over months, though it is sometimes lasting. Strenuous activity waits several weeks.
Bleeding beneath the skin, temporary weakness of the nerve branch that moves the lower lip, contour irregularity, and healing problems where smoking or poor circulation are factors. Each is reviewed against your own history.
For some necks, yes. Botox relaxes platysmal bands where the muscle is active but not yet widely separated, repeated every few months rather than fixing anything. Submental fat with good overlying skin can sometimes be treated with liposuction alone, through one small incision and a far shorter recovery. Which applies is an examination question. See non surgical aesthetics.
Premier Aesthetics is offering the following services in Syracuse, New York:
People often wait too long before they ask about surgery. They try to ignore the neck or cover it with clothing, angles, and posture. That usually only lasts so long.
You may be a good candidate if:
The right answer is not always surgery. But when non-surgical options stop doing enough, a neck lift can become the more practical choice. Straightforward. No drama.
A lot of people notice the change in photos first. Others see it in the mirror during normal morning routines. Some feel it when they put on a collar or necklace, and the shape underneath just feels off. That is usually the moment they start looking for real solutions.
Premier Aesthetics offers surgical care with a personal feel. That sounds simple, but it matters. Patients do not want to be rushed. They do not want vague answers or a hard sell. They want someone who will look at the neck honestly and explain what can be done.
Dr. Leo J. Urbinelli brings deep training and a strong eye for facial balance. He also understands that neck work often needs restraint. Too much tension creates a strange look. Too little does not solve the issue. Finding the middle takes judgment.
Some people come in thinking they only need one thing. Then the evaluation shows a different picture. That is useful. Better to know early than guess later.
A neck lift is rarely just about the neck. It affects the whole lower face. When the chin and jawline are more defined, then the face can look calmer and less weighed down. Even the eyes sometimes seem brighter. Not because they changed, but because the lower face stopped distracting them.
That is why neck work is often discussed alongside other facial procedures. The goal is harmony. A stronger jawline. A smoother neck. Less visual clutter.
A neck lift may also be part of a broader plan for facial rejuvenation, especially when age has changed several areas at once. Sometimes that means pairing it with a facelift. Sometimes not. The right combination depends on what you actually see in the mirror.
Dr. Leo J. Urbinelli’s expert neck lift surgery in Syracuse, New York, may be worth considering if the neck has become a constant source of frustration and non-surgical options have stopped helping enough.
It may be a strong fit for people who:
If that sounds familiar, a consultation can give you a clearer answer.
In general a necklift is for a patient who wants a more defined, sculpted jawline and neckline and under chin area. Whether it’s due to weight loss, aging or genetically a thick neck we can remove excess skin, deep fat pads and modify submandibular glands and deep neck structures to give a more refined and contoured neck line. This is typically done through incisions (cuts) under the chin and around the earlobe, ears.
Yes a necklift can be done in isolation, and in the correct patient this can look fantastic. But like most of us, our face and neck don’t age in isolation or sag in isolation, so most patients would benefit from a neck lift with a midface lift and possibly a brow lift. However, it’s not one size fits all and we can customized the plan to suit your goals, needs and anatomy.
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John Beau SaulTrustindex verifies that the original source of the review is Google.
Dr. Urbinelli was outstanding in every aspect. He took his time to explain everything so we all knew exactly everything occurring. In addition to his expert knowledge sand work, he's also very personable![]()
Colleen VolmutTrustindex verifies that the original source of the review is Google.
After doing a thorough research for a plastic surgeon, I had a consultation with Dr Leo Urbanelli I immediately felt at ease talking to him about what I was hoping to accomplish. His depth of his knowledge and skill as a surgeon became obvious as he discussed the variations of my options. Dr. Leo would look at a particular area of my face and tell me what he could do and how it would look. He spent a great deal of time with me and answered all my questions and concerns. We both decided what would be the best procedure for me. I am just 8 weeks post surgery and my face, neck and brow lifts came out so much better than I could have possibly imagined. The stages of my recovery were exactly what he said they would be. I knew what to expect and how I would feel as my recovery progressed. He truly takes great pride in his work and cares deeply for his patients. He has always been available day, night and even weekends. He is an incredibly talented surgeon and the most thoughtful person you will ever meet. He is a true artist.![]()
Debi SuarezTrustindex verifies that the original source of the review is Google.
I can’t say enough wonderful things about my experience. I was extremely nervous going into this, and from the very first appointment, he made me feel completely at ease. He took the time to listen, explain everything clearly, and truly understand my concerns. He treated a cyst-like spot for me and repaired an area that kept reopening, something that had been both frustrating and worrisome. The results have been amazing, and I couldn’t be happier. Not only did he fix the issue, but he did so with such care and precision. What really stood out to me was his kindness and attention to detail. At one point, he even noticed and studied some of my old scars, which honestly made me giggle—it’s clear he sees things through a very skilled and thoughtful lens. His passion for what he does really shows. I’m so grateful I trusted him with something I was so scared to do. I would highly recommend him to anyone looking for a talented, compassionate surgeon.![]()
Nikki Ann WaltersTrustindex verifies that the original source of the review is Google.
I met with Dr. Leo in 2025 with anxiety and hesitation, I left with hope. During my visit he was patient, empathetic, and kind. He brought to light an issue of Lipedema that has plagued me for decades. After two procedures, I can say his professional skills and bedside manner are unmatched. I’m looking forward to a life of no limitations and more confidence, while looking better than I have in years. Thank you!![]()
Emily DygertTrustindex verifies that the original source of the review is Google.
Dr. Urbinelli is the best! He performed a breast reduction on me in December 2024 and choosing him as my surgeon was the best decision I have ever made. My results are exactly what I asked for and my self-confidence has increased tremendously. I am now able to live an active lifestyle without being uncomfortable or in pain. I consulted with other surgeons and none of them made me feel as confident and comfortable as Dr. Urbinelli did. He treats his patients like family and it is so evident that he loves what he does. Anytime I had a question or concern, Dr. Urbinelli got me in the office within one or two days to address my concern (and often offered to do virtual appointments so I didn’t have to take too much time out of my day to travel to the office). Upstate NY is so lucky to have a plastic surgeon as knowledgeable, professional, and talented as Dr. Urbinelli. I would recommend him to anyone!![]()
Mary KlockowskiTrustindex verifies that the original source of the review is Google.
Dr. Urbinelli is everything you could hope for in a surgeon—compassionate, encouraging, empathetic, and incredibly responsive. From my very first consultation through surgery and recovery, he was attentive and never made me feel rushed, always taking the time to answer my many questions with patience and care. This experience has truly been life-changing. Not only am I thrilled with the results of my abdominoplasty, but my confidence and overall mental well-being have improved in ways I didn’t expect. I feel more like myself again and genuinely excited about the future. I cannot recommend Dr. Urbinelli highly enough—he is an exceptional surgeon and a truly caring professional.![]()
Monica DezaTrustindex verifies that the original source of the review is Google.
I am so happy with Dr. urbinelli s work! For my 43rd birthday, I treated myself to a midface lift and lower bleph. He was great, honest , gave me realistic expectations, responsive , kind and delivered exactly the results I was hoping for. We discussed several pathways to get the refreshed look I was hoping for, and he discussed it with me with so much patience . These are my before and afters only a short time after the procedure ! Thank you Dr!![]()
Karrie NewkirkTrustindex verifies that the original source of the review is Google.
⭐️⭐️⭐️⭐️⭐️ Dr. Urbinelli is absolutely outstanding. His attention to detail and pursuit of perfection are truly every patient’s dream. You can immediately tell he is not only highly skilled but also deeply passionate about his work. He takes the time to listen and ensures that everything is tailored exactly to what you need. Syracuse Plastic Surgery is the gold standard. Having such a talented, caring, and supportive team all under one roof is truly a blessing for any patient seeking the highest level of care and results. 🩷💎🩷![]()
Patricia MaycumberTrustindex verifies that the original source of the review is Google.
I cannot praise Dr. Urbinelli and the staff of Syracuse Plastic Surgery enough for the care which was given to me during my recent surgery and recovery. Dr. Urbinelli is caring person and an artist at what he does. He was responsive to all my needs especially due to an unforeseen issue during my recovery. Dr. Urbinelli even made a house call to teach my sister how to dress my wound. I traveled far from Las Vegas to Syracuse, NY because he is a reconstructive facial specialist. I am so pleased with my results. I highly recommend Dr. Urbinelli for any reconstructive or plastic surgery you may need.![]()
Sam BredenbeckTrustindex verifies that the original source of the review is Google.
I waited as long as possible to write this review because I was holding out hope that I could leave a rave, 5-star review, but I can't. I had a revision surgery in August of 2023, in an attempt to correct my breathing and fix countless issues the first surgeon left behind. Knowing this surgery wouldn't be a small task, I tried to remain patient and hopeful with Dr. Urbinelli and team that all would go great. It didn't. My breathing is the same, if not worse, than before (which is terrible). It feels like I am suffocating all day, every day. The aesthetic of my nose has gotten worse (fat, asymmetrical, twisted, etc.). The columella scar is still visible. Swelling refuses to go down. I still have a septal perforation, collapsed nasal valves, deviated septum, and enlarged turbinates. He used a cadaver rib, which seems to be curved and feels rock hard, which is extremely annoying. I have a foul odor that has been persistent since surgery. And when I can't smell that, my sense of smell is practically non-existent. The entire process has been miserable and extremely frustrating. I did everything (and more) that I was told. Taping, Vaseline, elevation, icing, no exercise, sprays, cleanses, follow-up appts. every single thing. Yet, I still can't breathe, my nose looks terrible, in my opinion...and I'm out thousands of dollars. I am bummed to leave a poor review because I truly did want it to be positive, but I can't at this time. The surgery failed, and now I'm left with very few options to actually get this fixed. Regretful is an understatement. Dr. Urbinelli is nice, did a good job with bedside manner, and the anesthesiologist did a great job. Unfortunately, the office staff and Dr. Urbinelli were unresponsive many times after surgery, but I gave them the benefit of the doubt. Overall, it is frustrating, mentally debilitating, and I'm at a loss for what to do next. If you're looking to get surgery done for breathing issues or reconstruction of the nasal area, I would suggest going to a nose specialist instead of a general plastic surgeon.
Dr. Urbinelli trained at NYU School of Medicine and Bellevue Hospital and completed a craniofacial and pediatric plastic surgery fellowship at USC and Children’s Hospital Los Angeles. He is an Active Member of the American Society of Plastic Surgeons, and all services sets out the full range. He will tell you when a neck lift alone will not deliver what you are picturing and a facelift is needed with it, a conversation better had before surgery than after. See the gallery.
If you have been looking for neck lift surgery in Syracuse, NY, Premier Aesthetics offers a direct place to start with our expert surgeon, Dr. Leo J. Urbinelli. You will get honest guidance, a thoughtful surgical plan, and care focused on natural-looking results from him.
Schedule a consultation to talk through your neck, your profile, and what kind of change is actually possible.
Book your visit today if you are ready to stop
covering the issue and start fixing it!