Why would my dr say that I need incisions by the front of my hairline in addition to the back for a Neck Lift? (photos)

It is very difficult to comment on your condition considering how minimal information these photos provide. You may consider starting with Botox to address muscle bands? It is impossible to see lower face and jaw and say whether skin laxity needs to be addressed. Anterior neck lift with incision underneath the chin may be an option? Second opinion consultation is recommended. Good luck.

Hello!
We can't see your full face in the photo. However, you have platysmal bands (the vertical neck folds you are seeing). Your doctor is planning to do a full facelift to lift the skin up and reduce those. It is possible that pulling only behind the ear could do it, but not certain. We'd want to see your full face to decide. Additionally, an incision in front under the chin may be helpful to place the edges of the muscle (those bands you see) together, but it is not always needed. You don't have a heavy face or neck (not a lot of fat), so that incision isn't always critical.

In my office we do neck lifts under the chin, behind the ear, or both. However, it may be that a full face lift (with the incisions your doctor mentioned) will be much better for you.