I smiled at the term "Pelican Pouch" as I had not seen the term applied to describe a person's neck :). Regardless of whether it's a Pelican Pouch or a Turkey Waddle, the ideal treatment is often a combination of techniques. Although the photo that you have provided is in the distance and there is no profile view or ability to palpate the neck tissues, it appears that you have some aging of the neck and lower face as well as moderate fat deposition in the chin region (submental area) of the neck. Rejuvenation of the neck always benefits from a surgical lift of the face, and in individuals with moderate to severe aging of the neck, a high-powered lifting technique, such as a deep-plane or high-SMAS facelift, is best suited to address faces in which a significant amount of tissue excursion is necessary. In addition, achieving an ideal neck profile also typically requires employing a procedure that tightens the anterior neck, such as an anterior platysmal plication. A platysma plication ensures that the convex appearance of the pelican pouch can be transformed in to a concave, youthful and slimmer neck profile. Based on the preliminary information provided by your photo, I suspect that the ideal technique, for you, would be a High-SMAS lift in conjunction with an anterior platysmal plication with simultaneous liposuction or open lipectomy (fat removal) from the neck. Please see the attached video if you'd like to learn more about how surgeons maximize rejuvenation of the neck in facelifting. Please also be sure to consult with at least two board-certified plastic surgeons with expertise in facial rejuvenation. Best of luck to you!