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

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.

I would agree that you are on the young side for a facelift however given the skin redundancy I think you will be underwhelmed with the results of anything other than a facelift. My recommendation would be a lower face and neck lift. Best of luck!