A 40 year-old lady underwent a deep neck reduction to achieve a more youthful neck contour. She was troubled by excess fullness under the chin and an obtuse neck contour, which had always been present regardless of weight fluctuations. Through this approach a reduction of the deep tissues including the submandibular glands, anterior belly of digastrics and deep seated fat was achieved together with tightening of the neck muscles at the front of the neck and the side. A small incision under the chin and also behind the ears was used. In these situations i.e. younger patients who have never enjoyed a tight neck contour, the surgery is much more challenging than neck procedures purely for ageing – which are more restorative than reconstructive in nature. At two months, she was delighted with the change and improved.