Hello and thank you for your question. From what I can tell based on the picture you have provided, there is some possible early/minimal jowling. This occurs with age as the soft tissues of the face start to descend and as we lose volume from fat atrophy and bone loss, resulting in the characteristic changes of facial aging. You appear to have some excess neck skin- I cannot see if there is platysmal banding in your neck. Based on all that, you could make an argument for getting a facelift at this time- but you could certainly hold off a little if you'd like. A facelift would be the best way to address jowls, lower face skin laxity, and soft tissue descent- there are different techniques to manipulate the SMAS layer (an important soft tissue layer under the facial skin) to really control the symmetry achieved in a facelift. At the same time, facial fat grafting can also be done to address volume loss and help further correct asymmetries and restore facial balance. This can be done at the same time as a facelift. With all that said, it is difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the one photo with one view that you have provided. I recommend for you to come see me or another plastic surgeon for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps! Best wishes, Dr. Donald Groves Plastic Surgeon