42 y/o, 5ft 7, 133lb, lost 70lb in 2 yrs - what type of neck lift & can it be done without a facelift? (Photos)

Thank you for your question. If you would like to improve skin laxity without opting for a full facelift, a less invasive neck lift, often referred to as a lower rhytidectomy, may be right for you. This procedure targets the neck directly while requiring smaller incisions to revitalize your skin for a tighter, more youthful appearance. If you’re looking for something even less invasive, neuromodulators like Botox can often be used to reduce the appearance of banding and wrinkles on the neck. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can asses your needs on a more individual basis.

In our practice, we perform a non-surgical face lift / skin resurfacing treatment using Renuvion Helium Plasma Radiofrequency. ​To get the most improvement with skin tightening, we combine Renuvion (formerly J-Plasma) with lasers (Fraxel, Clear + Brilliant, CO2), microneedling/PRP, Ultherapy and InMode FaceTite. I suggest getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer​​​​

Based on these photos, I would say that you do not have extra skin which will be worth of excision and tightening? After weight loss, your muscle bands, which were hidden, are showing in your thin neck; treatment with Botox would erase and weaken some of these bands. In person consultation with a board certified plastic surgeon familiar with surgical and non-surgical options (radiofrequency?), is recommended. Good luck.

The question is whether the main problem is loose skin or just visible muscle bands on the front of your neck. If the anterior neck skin isn't too loose, then a horizontal incision in a natural chin crease would allow access to your platysma muscles. A muscle plication (tightening) with short partial release of the muscles should correct the visible bands. However, if your central skin is actually loose, then you would need that same muscle work plus skin tightening from behind the ears, a standard necklift. The problem going forward is that your neck appears so slender with minimal soft tissue padding between the platysma muscles and skin, that you are at risk for visible muscle fibers (bands) occurring anywhere on your neck in the future.

Your viewpoint is very good. Having a necklift rejuvenates; but is not as 'obvious' to others despite the positive change. Some surgeons do not isolate necks from the face but anatomically, it is a good idea. The extent of the necklift and location of the incision depends upon the clinical examination