Do I need a neck lift? Is there another procedure that would tighten this skin? (Photo)

With minor surgery you could probably obtain some good improvement. The least involved would be a submentoplasty which could be done under local anesthesia and an incision in a neck crease beneath the chin. The skin could be smoothed and some excess skin removed. If the platysma muscles were lax they could be tightened also. A more definitive but more involved procedure would be neck lift performed with incisions around the ears to remove skin from the sides. Finally there are nonsurgical options which could help. Sofwave is an ultrasound based therapy to tighten the skin and smooth it. Sylfirm X is a bipolar radiofrequency technique to both tighten and smooth the skin. Sofwave is more or less "one and done". Sylfirm X requires a series of treatments. Both are done under topical anesthesia with minimal downtime.

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Ok I think your best non-surgical options include Morpheus8 treatments in a series or Ellacor. Ellacor for the neck is off label so you'll need to talk to your provider if they've had good experience with the type of changes you have. Neck lift would be the gold standard though. Best Wishes!!