I'm 44 years old & I'm planning to do nefertiti or silhouette lift. Which is the best? (Photo)

Thank you for a great question and for sharing your concerns.  The aging changes in your neck appear significant enough to consider a more significant procedure such as a facelift or neck lift which will give you long lasting results. If you decide to proceed with a Nefertiti lift or Silhoutte lift, just be prepared for subtle changes lasting for a limited time. I hope you find this helpful.Consult with a Board Certified Fellowship Trained Facial Plastic Surgery Specialist."This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Thank you for your question and sharing your photo.  I would recommend visiting with a plastic surgeon who offers both non-invasive and invasive solutions for the neck.  Based on the photo, it appears that you have some fullness and skin laxity.  Both can be addressed surgically with a neck lift and will give you the most definitive results.Non-surgically, I could propose a combination of treatments such as Coolsculpting mini, Kybella or the Profound SubQ to help reduce some of the volume.  In addition, treatments such as Ultherapy or Profound can help restore some more tone and bounce to the skin.  Together with a volume reduction and skin tightening procedure, you should see great results, but still not quite as definitive as the surgical option.

These two gimmicky operations will disappoint you. I seldom see any good results. A well performed facelift should give you a neck some result in the neck as well as reposition the fat of the midface and malar area to a more youthful position.