Thanks for posting your photo and question. Based on the photo and your age you are an appropriate candidate for a facelift and neck lift in my opinion. There is some irregularity to the skin and I would say it looks like you had previous liposuction years ago. What usually happens is after years this skin loosens up and because it is thinner the platysma bands show beneath. This does need to be corrected with a lifting type procedure. I would perform a facelift which involves tightening up the SMAS muscle layer. I would perform smart laser lipolysis to melt fat and tighten skin. Also, some mild liposuction to allow for a platysmaplasty to get further tightening of the neck. I believe these are the basic procedures needed to be performed to get the results you are looking for.
In our practice, a platysma plasty is always performed with a lower face and neck lift. The platysma plasty is a component of tightening the neck muscles. The neck muscles are tightened in 3 locations, along with tightening the facial muscles, removal of any fatty deposits in the neck ,and tightening loose facial and neck skin the. For many examples, please see the video and the link below
Unfortunately there is always the possibility of future central neck sagging after lower face and neck lift, irrespective of technique used. The younger you are, the better your skin tone, the healthier your lifestyle, the better your results and the longevity of your results. In optimal conditions, we hope that results last 10 years. If you want to maintain your youthful look, you may need another skin tightening procedure in the future as you will continue to age.
Based upon the one photo(view) provided---my opinion could change with addition views---
you appear to have more of a neck skin quality(elasticity) than laxity(excess)issue. An animation view would
Your left cheek is visible and appears very strong, providing excellent anti-gravity support. However your
mandible and chin areas seem more atrophic(weak) with aging.
It is possible that Ultherapy of the lower face in combination with fat grafting of the mandible and peri-oral
area, to provide structure and definition is all you would need...........
Hope this helps............
You raise a very valid point about the limitations of neck procedures in your type of neck issue. It can be improved with lower facelift and submental repair as part of platysmaplasty. However, skin texture problems such as yours will recur to some degree. Laser afterwards can also help.
The irregularities and skin textural changes in the center of your neck that are probably the thing that bothers you the most are also the greatest source of dissatisfaction after facelift/necklift surgery. The problem is that you have primarily skin changes due to sun damage and pulling on the skin or tightening the platysma muscle are not going to improve the skin. It will look great in the early postoperative period while there is swelling but there will be limited long term improvement in the skin texture (more than 6 months). This is based on my experience with complete elevation of the neck skin, and platysmaplasty as well as plastysmal transection. The greatest satisfaction we have with this problem is direct skin excision under the chin but you have to be willing to trade a well healed scar for the existing skin.