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's difficult to say without the benefit a formal evaluation. With significant neck sagging you would need a neck lift / facelift with muscle tightening (platysmaplasty). At the same time, lasers treatments (Fraxel, CO2, Erbium, Halo) or microneedling RF (Fractora, Intensif, Morpheus, PiXel8) can be performed to improve crepey skin or wrinkles. You need a formal consultation, as the neck can be treated with a combination approach:​ - Microneedling and laser treatments for texture - Botox, Dysport, Xeomin, or Jeuveau to help the Platysmal bands - Intensif, PiXel8, Morpheus or Fractora RF microneedling for crepey skin and lifting - Injectable fillers like Belotero, Restylane Silk, and/or Juvederm Volbella to improve lines and folds - Renuvion, ThermiRF, and/or InMode FaceTite for internal tightening - Ultherapy and Thermage for external tightening - regular Venus Legacy, Exilis Ultra, or InMode Forma treatments with facials to maintain tightness - PDO NovaThreads or Silhouette InstaLift cone threads for lifting and long-term collagen production See an expert for a full evaluation and treatment plan based on your individual situation and goals.

In many patients to achieve the best contoured neck, incision in front of the ear help lift the SMAS for jawline definition. Incisions under the chin are useful for tightening platysmal bands, at times the medial inner bands can be addressed by lateral pull on the platysma.

Thank you for your question. The reason to make an incision both in front and behind your ear, would be to more naturally redrape the tissue. Many surgeons will use that approach if there is enough excess skin that needs to be excised. I recommend consultation with a board-certified facial plastic surgeon to discuss further. Best of luck!