lost 20lbs and at my thinnest, would a neck lift be what I need? (Photos)

An in person evaluation is best, but from the submitted photos it doesn't appear you need a neck lift. Two options for you to consider are FaceTite and Morpheus8. Both are RF treatments. Morpheus8 combines the RF technology with microneedling to improve tone and texture. FaceTite uses the RF energy both on top of and just below the skin surface to tighten skin. Visit my website or a provider near you to learn more.

Thank you for your photographs. Your overall facial shape and jaw contour is excellent. You have a small amount of platysma muscle banding in your neck. As you note, the Botox has not remedied this and therefore a neck lift with medial suturing of the muscle, and then some lateral traction of the muscle should help flatten your muscle banding, improve your cervicomental neck angle and smooth your neck skin. Best wishes.

Often Botox is the first nonsurgical treatment in treating platysmal bands that are related to excess muscle activity. If neck bands are related to excess skin and sagging (maybe from weight loss), then Botox doesn't work. Nonsurgical skin tightening devices like Sofwave gradually help tighten chin and neck skin; results take 3 months and there is no downtime. Surgical neck lift both tightens the platysmal bands and addresses the excess skin with longer lasting results.

Thank you for posting your question here!My answer will be based on the limited information and pictures provided , for a more detailed and personalized plan please consult with your plastic surgeon.
It is hard to assess the issue based on the pictures you provided, not sure if the issue is platysmal bands or excess skin . But the issue is probably mild , I would start with the least invasive options first , if bands are the issue I will start with botox and if that doesn't work out then consider surgery like a neck lift , if loose skin is the issue , you can start with radiofrequency microneedeling or renuvion and if the results are not satisfactory consider a neck lift.I hope this helps, best of luck!

It is difficult to give you good advice based on these photos; an anterior neck lift with small incision placed underneath the chin would be an option to consider. Good luck.