Unfortunately, it is difficult to answer your question without having a formal discussion with you of your specific surgical goals and performing a formal physical exam. There is limited information that can be gained from the photo you have provided- I would need to have more views and higher resolution photos to even have a tentative discussion about the presence/absence of wrinkles and other details of your current face/neck which would influence potential treatment options. I would urge you to arrange a formal consultation with one or multiple plastic surgeons to thoroughly discuss your surgical goals, be formally examined, learn about all your options (including nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps! . Best, Dr. Donald Groves Plastic Surgeon