I'm 44 and my face looks gaunt and neck is sagging. What minimally invasive procedures would help?

your loss of volume can be improved using Voluma injectable filler. It is reliable and lasts two years. Fat sounds to patients better since it is permanent but very often patients end up with lumps and asymmetries which are very difficult to correct. A mini lift will also  help to remove excess skin in your face and or neck. See several very experienced facelift surgeons who will discuss with you the most minimal procedures as well as procedures that have actual merits so you don't waste your money. 

In order to improve the jawline and cheek hollows, I use a combination of VASER liposuction and thermiRF at the same time for this.  Noninvasive options such as thermage, ultherapy, kybella, and fillers can also be used.  Please get a formal consultation as in addition to the above,  lasers, microneedling/PRP can be used for texture tone and intensif microneedling/RF for fine lines and some tightening. Best, Dr. Emer.

Your pictures do demonstrate some loss of volume in the cheeks.  The main non-surgical option to improve this issue would be injectable fillers.  Adding volume to your cheeks would most likely improve some of the looseness you see along your jaw as well.  Your neck does not appear saggy to me, but there are some non-surgical skin tightening treatments such as Ultherapy or radio frequency that could potentially help.  

What you can see mostly in these pictures is some volume loss in the face.  The neck looks pretty good.  Your best bet would be either fat transfer or fillers to the cheeks.  this will help to replace the lost volume and will help to tighten up your jawline. 

To restore volume in the mid-face can be performed with fillers placed in that area in the office setting with to be minimally invasive, And temporary.  Cheek implants can offer a more permanent alternative. A revision rhinoplasty procedure can accomplish reduction of the significant hanging columella and alar retraction present. For more information and many examples of both procedures, please see the link and the video below

Based on your photos I would recommend fat transfer to cheeks, chin and jawline. ThermiTight to tighten the skin in the jowl and neck area. I would also question your desire for lip reduction especially after volume enhancement to the face.

 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  From the photos your cheeks are flat anteriorly (in the front), jowls are present and the chin is weak.  These factors combine to create a rectangular shaped face.  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face. When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.  "Jowls” are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:very small incisionsminimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)can be performed in 90 minutes or less, with or without general anesthesiano incisions within the hair = no hair lossexcess fat can be removedexcess skin removedcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-opI combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.Hope this helps.