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

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.

Thank you for asking this question. The changes you’re noticing don’t mean something is “wrong”, they’re simply part of how weight loss, muscle tone, and support structures shift over time. It’s completely valid to notice a shift in how your face and neck feel, even if the change is difficult to pinpoint.
In younger patients, changes in the neck and jawline are often not about aging, but rather about how support structures beneath the skin respond to things like volume loss, Botox, and even strong muscle activity.
The platysma, the thin sheet-like muscle in the neck, can sometimes lose tension or pull differently when fat volume decreases or when Botox is used repeatedly. While Botox softens visible banding, it also weakens the muscle’s tone, and in some cases, this can make the overlying skin appear looser. When combined with fat loss, the skin no longer has the same underlying support, which can make small shifts more visible.
This isn’t necessarily a sign that anything is wrong, it’s just the body’s natural response to change. The muscles and tissue are adapting.
In terms of treatment, a neck lift for someone your age wouldn’t be about “anti-aging” in the traditional sense. It would be more about redefining structure, addressing subtle laxity that fillers and Botox alone can’t, reshaping the platysma, restoring support, reducing width or fullness if needed, and refining the overall contour. It’s closer to sculpting than fixing, and often about reestablishing balance, not chasing youth.
We hope this offers some clarity around what may be happening beneath the surface. The most important takeaway is that feeling out of balance doesn’t always mean surgery is the answer. However, when surgery is considered, it should be approached with precision and understanding of what’s actually shifted underneath, not just what’s visible on the surface.

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.

Much more information is needed such as your age, and a full set of facial and neck photographs with your hair, pulled back and in a chin, neutral position, not smiling. If their skin laxity in the neck, that's gonna require a neck lift with skin tightening. Botox can be used for the plasma bands.

Based on the few posted photos, my recommendations, though they could change after a virtual consultation would be a mini face with full neck lift SMAS plication. Endo delayed treatment for jawline neck, Botox injections to neck bands. Fee 12,000 to $25,000. Best of virtual consult with.