42 years old and now seeing skin sag at jawline. How best to address this now, or wait until a facelift in a few years? (photos)

There are several options including minimally invasive skin tightening with RF devices or small incision facelift. The minimally invasive devices tend to produce minimal results so if you are looking for a significantly noticeable change I would recommend surgery. The sagging of the lower face is the result of skin and the layer beneath called the SMAS. The excision of skin and tightening of the SMAS would give you a more youthful appearance. 

Thank you for your question and pictures.  I would suggest sticking to having some fillers perhaps in the jawline or cheeks to balance your face giving a fresher appearance, however, this will not reduce the lax skin completely but just give some volume.  You would need to be examined to see whether you would be suitable for a facelift now or whether there isn't enough skin laxity to perform quite yet.The facelift I perform is under a local anaesthetic which means a significantly reduced downtime.
Most of my patients want a facelift however do not want the downtime associated.  The Concept Facelift, is the procedure I perform, which combines the latest surgical techniques with the use of local anaesthetic to dramatically reduce the risks associated with traditional facelifts, while significantly reducing the bruising and downtime of your recovery, from months to a matter of days. 
If you have lax facial skin, lost volume and feel that you have jowls and wrinkles on your cheeks and you look tired when you're not then the concept facelift can help improve your appearance. With concept facelift you will look natural and fresh just like the way you feel inside. There are no bandages, drains and hospital stay but with lasting results of traditional facelift techniques it fits with today's age.
This can be combined with resurfacing options such as chemical peels or laser which gives your skin a glow and helps the appearance of acne scarring. 
 Typically recovery period is 7-10 days as you do tend to bruise more with your eyes than facelift and necklift.  You would need to return for a follow up appointment 7 days later to check your healing progress.  This can be combined with lower eyelid surgery which I think will give you a fresher appearance.
What are the benefits of a local anaesthetic facelift?
Minimally invasive as it is a short scar facelift, although has the same effects as the Traditional Facelift as the SMAS muscle is tightened along with the skin.There is minimal bruising and swelling, especially when compared to traditional faceliftsAs the procedure is performed under local anaesthetic, you can go straight home following the procedureFull recovery in a matter of days rather than monthsSignificantly less risk than Facelifts performed under general anaestheticFresh, youthful and long lasting resultsPlease make sure you find a reputable and qualified plastic surgeon

This is really a wonderful question and one that I get asked very frequently.  For most patients, facial cosmetic surgeries can be done in the office under local anesthesia - mini facelift, mid face lift, neck lift, blepharoplasties etc. For example, bilateral upper & lower blepharoplasty, mid face lift, Short Scar facelift and neck lift usually takes me about 90 minutes in the office under local anesthesia. The goal is to have patients looking natural.I routinely tell people to take a few days to a week off work and to hide out but some people are very nervous especially celebrities and I usually tell them to hide out for two weeks. As with any scar on the human body, initially scars are red, hard and raised and it typically takes six months to a year for them to become a soft thin white line. I strongly feel that it's very important to have an honest conversation with your surgeon about your particular situation, lifestyle, work environment and specifically which procedures you're having done so that you both have the most honest answer about your recovery and are realistic with expectations and results.

Thank you for your question and I’m sorry you aren’t fully satisfied with the result of your Kybella treatment. The problem with fat reduction treatments is that they can make skin laxity worse if the skin is not tightened at the same time. While I would need to see you in person to make a definitive recommendation, I might recommend going forward with a lower facelift now. There are few non-surgical treatments that would successfully address the amount of loose skin you have and any improvements would be temporary. A surgical facelift removes the excess skin while repositioning tissue and muscle underneath for a look that is natural and long-lasting. Make sure you work with a board-certified plastic surgeon that can customize your surgical plan to produce an optimal outcome for you. 

You have a good handle on what you could benefit from. Without seeing what you looked like before, I don't know if I would have recommended Kybella for your original concerns. Based on your current pictures, I would not do anything that could make you look worse. When it's time, a well performed facelift should help.Sincerely, Dr. K 

Treatment of sagging skin after Kybella injection. A facelift will  re-position the excess skin  and muscle and skin as well as remaining jowl.  You have to decide if you want to have a more youthful face now or waiting five years for this. When it bothers you enough get a proper facelift from a very experienced facelift surgeon and avoid short term fixes. 

The jowl area is not just fat, or even skin for that matter.  Any type of fat removal or even localized skin tightening will often not address the problem if the original problem required repositioning of the jowl in the form of a lift.  If you research it, you will find that there is a risk of further fat loss with localized RF skin tightening, which is not what is needed. Fillers may present a temporary solution.  But in your case, a lift may be the solution even at this juncture.

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime. Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Hello  and thank you for your question. I recommend you consider either radio frequency such as Facetite or a facelift. RF will improve skin quality and provide a moderate improvement with very little downtime. However it will not address the bands in your neck which are from muscle laxity. Good luck! 

 The goal of a lower face and neck lift is to tighten loose facial and neck skin, tightening loose facial and neck muscles, lift the jowls, removing fatty deposits in the neck, in addition to a platysma-plasty which tightens the two neck cords