I have lupus and have struggled to keep my physical appearance youthful as I have lost some years due to being sick. (Photos)

A combination approach is needed to get the most improvement with skin tightening for the face and jawline. I recommend J Plasma, Nova Threads, lasers (Fraxel, Clear + Brilliant, Co2), microneedling/prp, ultherapy and rf treatments to get the best outcomes. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Thank you for your question and pictures.  There are many options depending on which is your main concern.  If you wanted a slender L shaped neck then neck liposuction could be a possibility.  You can also use facial dermal fillers to add volume to areas such as the chin, cheeks and jawline, giving these area a more defined contour.  Alternatively, you can brighten your skin with lasers, chemical peels, micro-needling, retinol skin care etc.  Please have a consultation with a board certified plastic surgeon to discuss your options.  All The Best