Thank you for your question regarding what to do with your neck. Based on your history and pictures, I would suggest a neck lift. You have fat under and above the platysma neck muscles and excessive neck skin. Your best option would be a neck lift. During a neck lift, neck liposuction is performed as well as direct removal of neck fat. Also, during a neck lift procedure, excess neck skin is removed. During the neck lift procedure, the platysma muscle or neck muscle is sutured together to give a defined neck. I suture the platysma muscle with permanent sutures to give you a permanently lifted, 90-degree neck and jaw line. The neck lift takes approximately 3 to 4 hours to complete. The neck lift is performed under general anesthesia or IV sedation. Plan to give yourself a 2-week recovery after a neck lift. Thank you for your question regarding what to do with your neck. If you cannot find an experienced, plastic surgeon in your neighborhood, consider traveling out of state. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, and RealSelf Hall of Fame.)