Thank you for your question! This is a very common question amongst patients who have noticed changes that bother them but don't know if they are ready for surgery. I tell my patients that non-surgical and surgical treatments are really treating different things and it really depends on their goals. Some patients are okay with slight improvements and some patients would like more dramatic improvements. There is absolutely no comparison in results from a face/necklift and non-surgical procedures. Regarding your neck, there is no non-surgical procedure that would be able to tighten your skin and reduce the midline fullness to the degree a necklift would provide. However, there are some devices such as a sofwave and ultherapy that can make small improvements. Regarding your jowls, these can only be lifted with a facelift. I have seen some patients with filler in the jawline to camouflage jowls, but I feel adding volume to the lower third of the face tends to widen it and masculinize the face. It is very common for patients to have tried several non-surgical treatments (ultherapy, fillers) and later decide they want something more to meet their goals. Adding significant volumes of filler and having multiple non-surgical energy device treatments may cause some difficulties with wound healing after surgery. Therefore, I tell my patients to stop these non-surgical treatments (besides botox) if they know surgical options are in their future. Regarding your lower eyelids, you have pseudoherniation of fat causing the hollow areas which is best addressed by a lower blepharoplasty to reposition this fat. Occasionally patients can get by with a small amount of filler in this area when there is only a slight hollow (typically patients in their 20-30s). Patients that have had filler in the under eye region could have a prolonged period of swelling after surgery so I typically do not recommend this. There are no patients that need cosmetic surgery, so it just depends how much your lower eyelids bother you. Lastly, a facelift would not address your lip lines. The best for lip lines is laser resurfacing with a fractionated CO2 laser. This can be performed at the same time as a facelift and would not increase your recovery. If you are going to laser the lip lines then I typically offer to do the whole face since it helps with pigmentation and fine lines that a facelift does not address and does add a significant amount of operative time or cost. I would consult with several surgeons either in person or virtually and look at their before and after pictures to ensure they can provide the results you are looking for. This is a very personal decision so you should feel very comfortable with your choice. Good luck!