Feeling depressed with fat under neck, lost definition in jowl area and cheeks, heavy nasolabial folds. Options?

Hello and thank you for your question. Based on your photograph, you may
benefit from a mini facelift with a neck lift.  If good technique is used,
this can be done with minimal scarring and can result in a natural look, not
over-done look, with rejuvenation of your face.  Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results. The most important aspect
is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Dear Laila,The procedure that would be most effective in eliminating most of your concerns is  face and neck lift.  This is the most effective surgical rejuvenation option that will restore the jawline contour and create a pleasing neck contour.  Melasma would be best treated with laser and long wrinkle under the eyes would most likely be amenable to Botox treatment.Best wishes!Dr. Konstantin

Dear Laila,Thank you for your question, and I am sorry to hear about your multiple facial concerns that are bringing you down. It is difficult to perform an assessment and offer recommendations based on photographs alone, and I recommend that you seek a consultation with a facial plastic surgeon or plastic surgeon for additional evaluation. The surgeon can discuss a variety of non-surgical treatments that may best address your issues and goals, including fillers, neurotoxins, laser resurfacing, and Kybella, as well surgical options such as facelift. 

If your problem is related to a significant weight gain, the first course of treatment would be weight loss. Depending on the extent of your facial aging the solution might require a chin implant to better define your jawline, submental defatting and or plication or preferentially a vertical facelift in combination with some of the above. Your skin issues can be addressed with the ZO skin line quite effectively. Droopy corners and smiling wrinkles might respond to Botox or dysport. Choose wisely, the cheap fixer uppers can cost you quite a bit with often disappointing results!Christian Drehsen, M.D.

You have outlined a long list of areas you'd like improved, and you have not defined what you mean by "minimum" cost.  In my experience when patients would like so many areas improved, minimum cost OVER TIME is actually to have surgery, since it will give you the longest lasting results, and spread over time, is a very good investment if you're a good candidate.  Not everything can be accomplished with surgery, and Without an exam, it will not be possible to fully evaluate you and give you recommendations. Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search. 

Thanks for sharing.  You appear to be a good candidate for a lower facelift and neck lift.  These procedures target your concerned areas and have high patient satisfaction rates.  Botox and peels will help your other areas of concern. Do some research on these procedures here on RealSelf and reach out to some of these experts.

Hi,Thanks for your question. I believe you would benefit from a full face lift combined with some laser resurfacing/IPL/BBL to treat your discoloration. Please consult with a board-certified plastic surgeon.

Thank you for your question and for supplying pictures. I can see that you would be an ideal candidate for the Concept Facelift, neck lift and neck liposuction.  This would help achieve a contoured L shaped neck Most of my patients want a facelift however do not want the downtime associated.  The Concept Facelift is the procedure I perform, which combines the latest surgical techniques with the use of local anaesthetic to dramatically reduce the risks associated with traditional facelifts, while significantly reducing the bruising and downtime of your recovery, from months to a matter of days. 
If you have lax facial skin, lost volume and feel that you have jowls and wrinkles on your cheeks and you look tired when you're not then the concept facelift can help improve your appearance. With concept facelift you will look natural and fresh just like the way you feel inside. There are no bandages, drains and hospital stay but with lasting results of traditional facelift techniques it fits with today's age.
What are the benefits of a local anaesthetic facelift?
Minimally invasive as it is a short scar facelift, although has the same effects as the Traditional Facelift as the SMAS muscle is tightened along with the skin.There is minimal bruising and swelling, especially when compared to traditional faceliftsAs the procedure is performed under local anaesthetic, you can go straight home following the procedureFull recovery in a matter of days rather than monthsSignificantly less risk than Facelifts performed under general anaestheticFresh, youthful and long lasting resultsAfter the procedure or before, a good skin regime such as Obagi Nu-Derm or a skin peel will help with the melasma
Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.  All The Best 

Thank you for your question.  Based on your pictures, I believe that you would be a good candidate for a facelift.  The concerns you have for your face and neck will be specifically addressed with this procedure.  During a facelift, the soft tissues around the jawline and neck are moved into a more superior and tightened position.  This helps to define the jawline, and removes the fullness under the chin, as well.  Liposuction under the chin can be performed to better help sculpt this area.  Also, the midface can be lifted as well, which gives a balanced appearance to the rest of the face.  I would consult with a board certified facial plastic surgeon or plastic surgeon who specialized in facial rejuvenation.  Here you will have a full evaluation and be able to review before and after photographs. I hope that this helps!-David Gilpin 

I would recommend an excercise/diet regimen to loose some weight and get back closer to an ideal weight.  Then afterwards, a mini or full facelift and possibly a lower lid blepharoplasty will correct issues with the cheeks, and jowls.