I treat this everyday in my practice. You do not need surgery. Properly performed liposuction with laser and physical fat removal will do fantastic to remove the fat, lift the skin, and contour the jawline. I pretreat everyone with Botox 1-2 weeks before surgery to relax the neck muscles, allowing for better retraction of the skin after surgery. Then after treatment we do skin tightening with Venus Legacy to improve the results and decrease the neck swelling. I suggest you only see an expert for treatment of this area as a meticulous surgeon is required to get great results and complications in this area can be devastating both medically and cosmetically. Sometimes after you'll need so filler in the creases where there are wrinkles, but most often this tightens and there is great improvement. Best, Dr. Emer.