Which procedure would address loose skin in the lower face and chin area? (photos)

The most effective procedures for addressing loose skin in the lower face and chin area are surgical options that directly lift and tighten the underlying tissues and remove excess skin. Here are the primary procedures:

1. Facelift (Rhytidectomy):

A facelift is a comprehensive surgical procedure that addresses signs of aging in the face and neck, including the lower face and chin.  
How it works: It involves making incisions (typically around the ears and potentially under the chin), lifting the skin, tightening the underlying muscles and tissues (including the SMAS layer), and redraping the skin to a more youthful contour. Excess skin is then removed.  
Benefits for the lower face and chin: A facelift can significantly improve:
Sagging jowls along the jawline.  
Loose skin under the chin (sometimes referred to as "turkey neck").
Deep creases along the nose and mouth (nasolabial folds).  
Marionette lines (lines running from the corners of the mouth down to the chin).  
 
Variations: There are different types of facelifts, including traditional, mini, mid-facelift, and deep plane, which can be tailored to address specific areas and levels of laxity. A lower facelift specifically focuses on the bottom third of the face, including the jowls and jawline.  
2. Neck Lift (Platysmaplasty or Lower Rhytidectomy):

A neck lift specifically targets the signs of aging in the neck and can significantly improve the appearance of the chin and jawline.  
How it works: Incisions are typically made around the ears and sometimes under the chin. The surgeon may tighten the platysma muscle (the superficial muscle of the neck), remove excess fat, and redrape the skin to create a smoother, more defined neck and jawline.  
Benefits for the lower face and chin: A neck lift can address:
Loose, sagging skin in the neck.  
Vertical neck bands.
Excess fat under the chin (double chin).  
Indirectly improve the definition of the jawline.  
Combining Facelift and Neck Lift:

Often, a facelift and neck lift are performed together to achieve a harmonious and comprehensive rejuvenation of the lower face, chin, and neck. Since these areas age together, addressing them simultaneously can yield the most natural and balanced results.  
Non-Surgical Options (Provide More Subtle Improvements):

While surgery is the most effective for loose skin, some non-surgical treatments can offer mild to moderate improvement:

Dermal Fillers: Can add volume to areas that have lost support, indirectly lifting the surrounding skin and improving contours along the jawline and chin. Results are temporary.
Thread Lifts: Involve inserting dissolvable threads under the skin to lift and tighten the tissue. Results are less dramatic and long-lasting than surgery.  
Energy-Based Skin Tightening (Radiofrequency, Ultrasound): These treatments can stimulate collagen production and provide some skin tightening over time, but the results are typically subtle and best for mild to moderate laxity.  
Injectable Fat Dissolvers (e.g., Kybella): Primarily target excess fat under the chin but can sometimes improve the contour and appearance of mild skin laxity in that area.
Recommendation:

For noticeable and long-lasting improvement of loose skin in the lower face and chin area, a facelift, a neck lift, or a combination of both are the most effective treatments.

The best course of action is to consult with a board-certified plastic surgeon experienced in facial rejuvenation. They can assess your specific anatomy, the degree of skin laxity, and your goals to recommend the most appropriate procedure or combination of treatments for you.

I recommend either a MACS facelift combined with a neck lift or a standalone neck lift, depending on your specific needs. The MACS facelift, when combined with a neck lift, provides a more comprehensive rejuvenation by addressing both midface sagging and neck laxity. Alternatively, if the primary concern is excess skin and laxity in the neck area, a neck lift alone would be an effective solution for achieving a more youthful and defined appearance.

The best option to address the midline neck area and jowls is a face and neck lift. With a lower face and neck lift, the laxity in the midline can be tightened. IN preparation, things like skin resurfacing (laser, peels, micro needling with RF) can help tighten up the skin in order to get the best surgical result.
A deep plane lower face and neck lift will resuspend the neck muscle as well as some of the fat pads in the lower face that has descended. Any minimally invasive technique alone (liposuction, micro needling with RF) will not address the laxity of skin so this option alone would not be the best.