Hello Witty023786 in Mesa, Arizona, Thank you for reaching out with your question about the best approach to address your neck concerns. Based on the information you've provided and the images you've shared, it's important to carefully consider your options, especially in light of your goal to lose an additional 20 pounds. From the analysis of your pictures, it appears that the primary issue is excess neck skin rather than excess fat. This distinction is crucial because neck liposuction, even with NeckTite, primarily targets fat and may not be effective for skin-related concerns. In your case, since there isn't significant fat to address, liposuction may not yield the results you're hoping for and could potentially worsen the appearance of the neck by leaving more loose skin. As you plan to lose more weight, it's likely that the amount of excess skin in the neck area could increase, making the need for a surgical intervention more apparent. A neck lift, which involves the removal of excess skin and tightening of the underlying tissues, seems to be the most appropriate solution for your situation. This procedure can provide a more contoured and refined neck profile, aligning with your aesthetic goals. Given that further weight loss might exacerbate the skin laxity, it would be wise to consider undergoing a neck lift after you've achieved your weight loss target. This way, the surgery can be tailored to the final contours of your neck, ensuring optimal results. It's important to have a detailed consultation with a board-certified plastic surgeon who can evaluate your neck in person, discuss your goals and concerns, and provide a personalized recommendation based on your specific needs. Best wishes as you make your decision and continue on your journey. Sincerely, Dr. Katzen