What Has Caused This Bazaar Crepe Effect on my 46 Year Old Neck and What Procedure Will Fix It? (photo)

 You have the signs of the early aging neck with loose skin and jowls. You need a facelift for this and not just a mini lift to reposition your jowls and remove the excess skin. Choose a very experienced facelift surgeon for this.

From the picture provided, you would benefit from a lower facelift which includes a necklift. This would address lax muscle and sagging fat in the neck and jowl region and create a more defined neck and jawline. I frequently add fat grafting to the cheeks at the same time in order to provide a more comprehensive, natural, 3 dimensional effect. Consult with at least two experienced facial plastic surgeons for options.