Facelift/lower facelift at 40 (my neck skin is so saggy)? (Photos)

Of course, a consultation is necessary, but it appears that, with your weight loss and loss of volume, the structures of the face, as well as the skin have sagged, and a lower face/neck would be best, even at your age. Picture also a trampoline that has been bounced on and stretched. Simply tightening in one direction such as posteriorly like a necklift, will probably not render the result that you want. It is helpful to tighten the trampoline in all directions. The upward pull that a facelift will give you, will also pull upward on the platysma muscle and skin of the neck. Try pulling upward on the face, and watch your neck. You will see some improvement from that upward pull alone. The good news is that, at your young age, your healing and regeneration capacity is great, so it is likely that you will get a nice result.

Thank you for your question and sharing your photographs.

In general, the pattern of skin laxity under the chin which is shown in your photographs benefits from a combination of neck lift and facelift. The placement of the scar for the facelift may be more advantageous in front of the sideburn rather than in the temple. This will allow more effective removal of skin excess from the area under the chin.

There is also some fullness under the chin which may benefit from direct access to the neck to reduce it. To understand better whether there is skin laxity only or volume excess under the chin you can look in the mirror when you are lying down completely flat. If the contour of the neck is very good, you are dealing with skin laxity. If there is still volume persisting when you are lying down, surgery would need to address it for best results.

The skin excess lower in the neck will be removed effectively through the scars behind the ears.