40 year old, not sure what approach to take for jowls, recommendations/advice appreciated (Photos)

Based on the minimal jowls seen in these photos, it is likely that a small cannula liposuction procedure would be sufficient. This can be performed under local anesthesia. For the mild anterior neck deformity and platysma bands, Botox may be helpful in improving it. Alternatively, an anterior neck lift is also an option to consider. Good luck.

I can see that you have had multiple non surgical procedures with minimal to no results. Some time these procedures give you an initial improvement because of the swelling, but the net effect of any radio-frequency procedure is loss of subcutaneous fat and volume that would make things worse in the long run. It is time for you to discuss your gauls with a plastic surgeon who can offer you an operation to address your concerns. I see some laxity under your chin and depressions under your eyes. There are folds in the corners of your mouth and slight jowls. A facelift could definitely give you improvements in all those areas. You might also require a lower lid blepharoplasty and some fat grafting. Please look at my pictures for further clarifications. Also you may see my instagram photos @betterplastisurgery.

Thank you for your question and photos. It appears that you have tried many non-invasive procedures with limited success. A short scar or mini-facelift is designed for individuals with limited facial laxity. This procedure, which can be performed under local anesthesia will give more dramatic improvement and longer lasting results then the procedures you have tried. I recommend you visit with a Board Certified Plastic Surgeon to discuss options for facial rejuvenation.