What are my neck lift options?

This is a very good question and brings up a number of very good points.
The two general types of procedures that would be discussed with you in my practice are a "Minimal Incision Necklift" and a Facelift; I will explain the difference. Direct removal of skin via a Z plasty is also possible but generally only applies to a small sub-category of patients willing to have a mid-line scar.
A "Minimal Incision Necklift" involves an incision just under your chin, below the chin crease, roughly 2.5 cm in length (this will vary according to the patient) and a 1.5 cm incision behind each ear. The general concept is to judiciously remove fat excess, stitch together the platysma muscle ( a paired, thin, long sheet of muscle visualized when you strain your neck) and place an interlocking suspension suture from side to side to help to maintain the contour of the neck. No skin is removed, because generally more skin is required to fill a concavity than to maintain a convexity. This axiom holds true up to a certain limit. I would agree that wth other posters on this topic that most patients in their late 50's are getting to to the point where the degree of excess skin cannot be addressed by this technique and skin removal becomes necessary.
For patients with this certain degree of skin excess, a traditional facelift is generally the best approach because it allows for removal of excess fat, a platysmoplasty/ muscle resuspension, and removal of skin excess via concealed incisions. Any good facelift surgeon should be able to make the incisions look inconspicuous by following a number of time honored surgical principles. As I tell my patients: If your incisions don't look good, I don't look good, and I do not want to have that happen. A responsible, ethical surgeon who takes pride in his work has a vested ineterest in an excellent outcome for his/her patients.

There is another type of neck lift that I routinely perform in my practice that hides the neck lift incisions behind the ears – specifically, in the crease of the ears where the ears meet the back of the skull. My female patients always appreciate being able to wear their hair up without incisions being obvious, and male patients appreciate this camouflage because most men have shorter hair. As a board certified plastic surgeon, my belief is that all patients must look as if no one has touched them, which is why I work very hard in the operating room to provide the best results possible. I suggest consulting in person with another board certified plastic surgeon for a second opinion to see if a different technique would be recommended. .

Hi and Thanks for the question!
The best treatment for loose neck skin would be a necklift or a facelift with a necklift component. The incisions for a necklift and facelift are essentially the same.Early recurrence may indicate the need for better attention to tightening your neck muscles and deeper structures which actually hold-up over time. Tightening the face, neck or any other part of the body using only skin-tightening procedures will tend to recur early and often because the skin is designed to stretch and relax.
I would suggest you seek a plastic surgeon to perform a deep necklift addressing the tissue below the platysma muscle and then tighten the platysma muscle much like a tummy tuck tightens the abdomen and keeps it from bulging. 
Once the deep neck is tight - the excess skin is carefully redraped and tailored to fit the new neckline.
Best of luck,
Dr. Karan Chopra
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Minneapolis Plastic Surgeon
Face ⨀ Breast ⨀ Body Expert
Johns Hopkins Trained
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