Loose, saggy skin under chin, 42 year old female. What are my best options? (photos)

It is best to begin by consulting with a board-certified surgeon in-person. 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 if you are a #candidate for #rejuvenating the neck. Chin deficiency with the neck and jawline are also taken into consideration. A weak #chin implies a lack of chin support for the skin along the neck line. 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.
Although, you are trying to avoid a facelift, you may benefit best from  one. Patients who desire facial rejuvenation that is affordable, quick, and effective should also consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift, individualized for each patient, that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.The best candidates for #LiteLift are non-smoking patients 35-60 years old with early changes of the lower face and the neck. But whose skin has elasticity with well defined bone structure. Older patients who cannot or do not wish to have a longer operation or general anesthetic can be improved with a Lite Lift™.
A board certified plastic surgeon should evaluate both your anatomical features and aesthetic goals to suggest which procedure best suits your needs. In some cases there may be more than one option to choose from. If you are not a candidate at the time of your #consultation, your board surgeon can recommend non-surgical alternatives to address your concern. 

The best option to get the best result would be surgical. A neck lift with or without face lift would redrape the loose skin in the neck. Additionally, the vertical bands that appear on your neck when you grimace appear to be plastysmal banding, which can also be addressed with a neck/face lift. The loss of collagen in our skin can result in the thin, crepy skin that we all experience, and fractional laser treatment at lower settings can help stimulate regrowth of healthy collagen, thus tightening the skin and soft tissues of the neck. Another option is Ultherapy for skin tightening. This device uses ultrasound technology to treat the tissue under the skin in order to stimulate skin tightening. Discussing these surgical and non-surgical options with a specialist would be recommended to determine your best course of action. Best of of luck.

If you’d like to avoid surgery but still improve the quality of your neck skin, ThermiTight combined with chin liposuction is probably your best option. We call this combination ThermiSculpture at our center and our patients have been thrilled with their results. 
Liposuction removes the excess fat under the chin. The ThermiTight probe is inserted into the same incision used for the lipo. ThermiTight uses radiofrequency (RF) energy to tighten the skin, creating a nonsurgical lift. 
Both liposculpture and ThermiTight take skill to perform well. ThermiTight demands that the physician monitor the temperature both underneath and on the surface of the skin and liposculpture is an art that takes years to master, so choose your doctor carefully.
It will take about 6 months for your skin to tighten, but the effects should last about 7 years Please find an expert board-certified dermatologist who can offer you ThermiSculpture to rejuvenate your neck.