My Neck Looks Wrinkly and The Muscles Tighten Up When I Speak. What Can I Do? (photo)

"A combination approach would give the most improvement. Nonsurgical options such as Kybella, PDO NovaThreads, and Ultherapy do well in combination for skin tightening, but the results are mild compared to surgical options.

I would recommend a VASER Hi-Definition Liposuction with ThermiRF, Renuvion (J Plasma) and InMode BodyTite to contour and tighten the chin and neck. A neck lift can be performed at the same time, if you're a good candidate. I suggest seeing a board-certified cosmetic dermatologist to develop a personalized treatment plan that works for you. Best, Dr. Emer.​"

It's best to begin by consulting with a surgeon in-person to discuss your options. The presence of banding down the front of the #neck, and, amount of excess skin and condition of your skin are among some factors which determine what treatments will best rejuvenate your neck . During your initial examination, your chin will be evaluated along with the neck and jawline. A weak #chin implies a lack of chin support for the skin along the neck line. In younger individuals a chin implant alone is usually all that is needed to improve the appearance of the neck. Subsequently, it will also improve the overall #balance of the face and can create the illusion of a smaller nose. As a stand-alone procedure, chin augmentation can be performed in the office under local #anesthesia. For individuals with signs of #aging in the neck, a chin implant added to one of the recommended procedures above, will provide optimal results.If you are not a candidate at the time of your #consultation, your board certified plastic surgeon can recommend alternatives to address your concern. Consulting with a board-certified plastic surgeon who specializes in #neck lift procedures is important to ensure you are receiving the best advice, care, and surgical experience possible.

Neck cords may respond well to Botox as long as the skin tone is OK.  If Botox doesn't help then a neck lift may be the next step

Botox along the edge of the platysma muscle can give some temporary help to platysma banding.  Later on, they will need surgical repair.  I think skin tightening technology is a waste of time and money.

You are describing 2 issues:

1. Hyperactivity of your superficial neck muscle known as platysma;

2. Early skin laxity.

When I examine the photo you provided I would describe these issues as "early" and "mild". I think you can expect some nice improvements with non-surgical treatments such as Ultherapy and Botox or Dysport.

Consult with a facial cosmetic surgeon for a thorough in-person assessment.

Lastly, smoking does do significant harm - also related to aging; but you knew this already.