you have great bone structure but you have very loose skin so you NEED TIGHTEING. you can do a lift surgically, if you dont want that then you can do renuvion or facetite with less downtime. in the office you will need regular maintenance with moprheus every 2-3 months, thermage /ultherpay every 6 months, to keep your skin tighter. and botox on the neck every 3 months. if you want a comprehensive plan I suggest reaching out. co2 will NOT tighten your neck but long term will improve teture and can be done but I would pretreat with emeragecosmetics ENLIGHTEN peel and AERIFY microrolling system. consult us. if you want a dramatic change necklift/facelift, Implants and fillers will give you that. noninvasive will improve the area and facetite, threads, morpheus, and fillers can be used. start at home dermarolling to tighten you skin, see emeragecismetics.com where we do free skincare consults daily and recommend MTS roller with anteageMD ampules daily (see dermarolling package). With significant neck sagging you would need a neck/face lift with muscle tightening (platysmaplasty). at the same time lasers (fraxel, co2 or erbium( or microneedling RF (fractora, intensif) can be . performed to improve the crepe skin or wrinkles. You need a formal consultation, as the neck can be treated with a combination approach: 1. micro needling and lasers for texture 2. botox, disport or xeomin to help platysmal bands 3. intensif or fractora RF microneedling for crepe skin and lifting 4. fillers like belotero, restylane silk, juvederm volbella to improve lines and folds 5. neck/face lifting if sagging is prominent or early starting +/- platysmaplasty (muscle tightening) 6. J plasma/Renuvion, thermiRF, inmode facetite for internal tightening 7. ultherapy and thermage for external tightening 8. regular Venus legacy, exilis ultra, or inmode forma treatments with facials to maintain tightness 9. PDO novathreads or silhouette instalift cone threads for lifting and long-term collagen production see an expert for a full evaluation and treatment plan based on your individual situation and goals. Best, Dr. Emer