What can I do about my wrinkly and saggy neck, should I get neck lift combined with a facelift?

Yes, I believe neck lift would be the best choice for tightening of loose neck skin and more youthful appearance for years to come.  Non-surgical alternatives mostly preventive in nature, and cannot offer the same quality outcome, although they're costly and require multiple sessions.  You do not need a facelift at same time, but extension of tightening to cheeks would be worthwhile to forestall loosening of skin around mouth for a few years.  Kligman formula and sun protection recommended for facial skin.

The neck can get sagging skin for many reasons including a lot of sun exposure, weight gains or loss, pregnancy etc.  Aging of the neck is very common before aging of the face.  It's one of the things that can be very frustrating to patients of all ages especially the turkey neck in patient’s with a family history. 
The face and neck keep changing as you age. Some of the changes are at the skin level, some at the deeper levels like the fat, retaining ligaments or muscles. There are several nonsurgical and surgical options to treat each of these different areas. Some can be done together and it really depends how much improvement you want to see as well as what part really bothers you. If there is significant sagging, surgery is usually the preferred procedure but can still be combined with injections and laser treatments before or after surgery.  
A simple way to think about it - think of surgery as addressing any excess skin and laxity as well as removing fat.  Think of laser as tightening the skin levels. Injections like Kybella can nonsurgically help diminish the fat and offer improvement and there are all sorts of laser procedures that can tighten different layers as well.
Most of these procedures can be done safely in the office and the results are very satisfying. An in-office private consultation and examination with a board-certified plastic surgeon would be the best way to fully see and address your specific concerns and determine the right treatment plan.
I hope this helps answer your question.  If it does, please take a moment to up vote this answer on the “respond” button on the top right.  

Dear gula13,A facelift usually includes the lower half of the face and neckThe reason we combine the two because all the muscles are attached together (in the face and neck)After lifting, the skin needs to be re draped and removed, so if you only do the neck, you can be left with some bunching or pleats in the skin that look unnaturalYou have great skin for a lower face and neck lift and I think that would suit you bestWhen you are ready, please go to a consultation so your options can be reviewedDr. Nima

Member, American Academy of Facial Plastic and Reconstructive Surgery

Board Certified Facial Plastic Surgeon
Board Certified in Head and Neck Surgery

Without all views of your face and neck - it's difficult to give you the best answer. The term facelift also includes the neck. In our Practice we address and include the neck as well as the cheeks in the term- Facelift. The success of a facelift will be defined and determined by the quality of the neck result.

I think you would be an excellent candidate for a necklift. Unlike many surgeons who feel that it must be done with a facelift, I have found that it can be separated and performed in isolation.

Thank you for your question. The real "power" of a face lift is what is done with the neck. A face lift/ neck lift will tighten the skin, but it will not improve the quality of your skin. In my experience, none of the non-invasive technologies are great at improving the texture of the neck and helping with the crepey skin. Profractional laser resurfacing can help, but there is no "wow" procedure. The face lift will remove the excess skin and tighten the neck. The improvement will be subtle, but very nice. Make sure you see a board certified plastic surgeon who is a member of ASAPS and specializes in facial rejuvenation procedures. Best of luck.

Thank you for sharing your pictures.  My opinion after seen your pictures is that a lower face with a neck lift will alleviate the concerns  that you have in the more permanent  and natural way

A couple of radiofrequency treatments such a Fractora Rf would do wonders for your neck and is easy to undergo. It tightens the loose crepy skin very well.  There is about 3-4 days downtime with each treatment and are usually done 3 months apart.  You are not ready for a lower face/neck lift yet.

Hello guia13,
It’s a pleasure to answer your questions! I would recommend you getting neck contouring with Embrace Radio Frequency (RF). This is FaceTiTe and NeckTite combined with Fractora, to tighten the sagging skin around your face and neck and obtain long-lasting and natural-looking results. FaceTite is a minimally-invasive, advanced contouring device, FDA-approved and readily available nowadays. Patients who would prefer to avoid surgery and general anesthesia, opt for FaceTite and NeckTite to achieve results similar to a facelift. Recovery time required for this procedure is remarkably short (24-48 hours), and also pain-free, relative to traditional lipolysis methods. This scalpel-free, and scarless skin treatment is typically performed in the office, under local anesthesia. Using radio-frequency (RF) technology, the surgeon places a small probe beneath the skin that heats the tissues causing them to contract and tighten. Furthermore, FaceTite and NeckTite can be combined with Fractora to provide anti-aging improvements on skin tone and texture for a more youthful and radiant appearance through ablation and skin resurfacing. Fractora provides dramatic wrinkle improvement by fractionally ablating the skin and restructuring deeper tissue. This FDA-approved technology delivers radio frequency energy to the skin through an array of pins producing localized heat and small micro-lesion dots in the treatment area. Downtime is minimal relative to a facelift, as you can resume work and regular activities as soon as the next day after the procedure. Fractora results will continue to develop over the coming months, as new collagen is created. Each session will further ablate and resurface the skin, resulting in a reduction of wrinkles, skin laxity, textural irregularities, and scarring, without going through the inconveniences of invasive cosmetic surgery and general anesthesia. Request an in-person consultation with an experienced plastic surgeon to assess your candidacy for FaceTite, NeckTite and Fractora, and discuss your specific needs and cosmetic goals. Best regards! Dr. De La Cruz.

It is true that neck lifts are often done at the same time as lower facelifts. A facelift/necklift will improve the laxity of the neck skin and improve the appearance of the lower face by tightening the jawline. It is hard to tell from your photos if this would be the best treatment for you. There are non surgical treatments such as skin tightening, combined with medical grade skin care, that can improve the appearance of creapy skin.I suggest you see a surgeon who specializes in facial rejuvenation surgery and also has non surgical treatments to offer, for an in person evaluation.