I'm 59 years old. What are my options for getting rid of double chin and loose neck skin without a face or neck lift? (photos)

Skin laxity under the chin, also known as “turkey neck,” is a common complaint among men and women alike. This issue usually consists of some submental fat that has accumulated under the chin, as well as loose skin that exacerbates the problem. Because the problem is twofold, the solution also requires combination therapy that can be done in one procedure. 
Submental fat can be eliminated using a gentle lipo technique that uses tumescent fluid to minimize trauma to surrounding tissue. The procedure can be performed using local anesthetic and downtime is generally minimal. Immediately following liposuction, ThermiTight is used to reverse much of that skin laxity and create a smoother contour under the chin by delivering deep heat with a radiofrequency probe. I recommend finding a board-certified dermatologist who can perform this treatment to your precise needs for the best possible result. 

I appreciate the photos you included with your question. Based on what I am seeing, I am not sure a nonsurgical treatment will work best for you. While chin liposuction will eliminate the submental fat underneath the chin, the removal of the fat is likely to make the skin laxity in the area even more pronounced. It is very possible you will need a lower facelift and possible neck lift to achieve the results you want. These procedures can be performed at the same time for most patients, giving you full results with just one round of anesthesia and one recovery process. Make sure you work with a board-certified plastic surgeon to ensure your procedure is both and safe and successful. 

Liposuction is an excellent option for removing stubborn submental fat under the chin and creating a more defined jawline. However, if there is skin laxity, that can be exacerbated by performing liposuction alone. I would probably recommend a combination of liposuction and nonsurgical skin tightening to produce the best possible results for you. 
I use the Awake lipo technique, which can be done using local anesthesia and only requires a few days of recovery. Incisions to insert the small tubes for suctioning out fat do not leave much visible scarring behind. ThermiTight is a skin tightening procedure that delivers radiofrequency energy deep into the dermal structure via small probes. As the tissue is heated, it constricts. Collagen production also increases, creating smoother, firmer skin from the inside out. Always work with a doctor who is board certified and experienced in these procedures to ensure an optimal outcome. 

Chin liposuction, more accurately termed submental liposuction, can radically improve jaw and chin contours without making any noticeable scars in the appropriately selected patients. Face Tite can tighten any saggy skin resulting from the lipo. Consult with a board certified PS who can determine if the minimally invasive technique would work for you or whether a neck/face lift would be more appropriate.

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime. Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Unfortunately with increased aging the minimally invasive procedures produce minimal results. Based on your photos and degree of aging any type of minimally invasive procedure alone will have minimal effect (for example liposuction) and can even make the excess skin problem worse. I would recommend that you consider a necklift surgery which can be performed under local anesthesia and oral sedation. It is very safe with local anesthesia.  In this way, skin can be removed, liposuction can be performed, and the neck muscles tightened in the front to provide the  most significant result.

The issue you are concerned with is that what use to be on your face is now hanging on your neck. You have lost your jawline definition and now have jowling, a deep pre-jowl notch, marionette line and a full hanging neck. The best and most complete treatment would be a lower face/neck lift. However, you may get significant improvement with the Embrace RF (FaceTite + Morpheus8) which is bipolar radio-frequency minimally invasive treatment under local anesthesia. This should provide you with 60-70% improvement. Please consult with an experienced facial plastic surgeon to discuss your options.

Liposuction of the neck, under the chin, is usually done with just local anesthesia.  Liposuction can reduce the fullness due to fat under the chin, but it will not tighten existing loose skin.  The best method to tighten loose skin of the neck is normally with surgery.  One non-surgical option to help tighten neck skin, to a lesser degree than with surgery, would be with FaceTite.  This is a radio frequency treatment that delivers heat to help produce tightening.  FaceTite can be performed at the same time as liposuction under the chin.

At your age your skin elasticity is not as good as it used to be. Having liposuction will quickly compromise your skin in regards to aesthetic appearance.A facelift with liposuction or open direct surgical fat Excision is probably a better option.I don’t think any non-surgical skin tightening procedures will be sufficient to compensate for the skin laxity that liposuction will have.Most patients don’t do well with liposuction after the age of 50.these are general statements and subjective to some degree.my practice is devoted exclusively to liposuction and fat transfer procedures. Personally I would Steer you away from it or at least explain the implications. You could have conservative liposuction with minimal skin impact but the results will also be minimal.I suggest having a few in person consultations with local board-certified plastic surgeons who specialize in facial rejuvenation.These are generally going to be more senior plastic surgeons.Best,Mats Hagstrom MD