Hi, I have performed many facelifts and neck lifts for over 30 years and have performed many minimally, invasive SMAS facelifts. From the photo the chin is quite weak and there is some excess skin below the chin. Non smiling photos of your face from the front and side, in a relaxed position, would help in the evaluation. When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face looks short, de-emphasizes the lips and allows early formation of a "double chin". Chin Augmentation using a silastic chin implant will add forward projection to the chin thereby creating harmony and balance to the lower face. Using the same incision, liposuction can be performed to reduce any excess fat and excess skin can be removed. I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty. I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone. In my opinion, you are a good candidate for chin implant surgery. By itself as a stand alone procedure or along with chin implant surgery, some of the excess skin below the chin can be removed using a small, curved incision under the chin by about 70% or more. If anterior platysma bands are also present or the maximal amount of neck skin is to be removed, a "formal" neck lift can be done. In the latter, the face and neck tissues are elevated using a curved incision around the front of the ear that continues in the crease behind the ear and then 3 inches into the posterior hairline. The tissue is dissected from that point all the way across the entire neck to the same position on the other side of the head in a dissection that is as long vertically as the entire neck. The Platysma muscles are tightened using a curved incision under the chin and each side is pulled upward and back again being tightened at a line behind each ear (under the tissues). Since the skin flap pull is up and back at a 45 degree angle, this will pick up any tissue laxity along the jaw line or "jowls" which must be dissected and flattened out using a lower facelift (incision around the front of the ears). If this isn't done, pleats of excess skin will appear below each ear. Compared to direct excision or a minimally, invasive SMAS facelift (described below) a formal neck lift is an extensive surgery taking 4 1/2 to 5 hours with large incisions, post op drains and pressure dressings, possible hair loss and months of recovery. If you have "jowls” in the lower face, these represent sagging facial tissues and the primary indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed. My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits: very small incisions and no incisions extend or are placed within the hair.minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)can be performed in 90 minutes or less, with or without general anesthesiano incisions within the hair = no hair lossexcess fat can be removed from the face and neckexcess skin removed from the face and neckcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-opI combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.In comparison, energy based non-surggical skin tightening mechanisms (RF, Ultrasound, etc) typically shrink the skin several mm's. There are 25.4mm's in one inch. In comparison, a formal neck lift, direct excision of the skin below the chin and the minimally invasive facelift described here are all capable of removing 2 to 3 inches of skin which equals 50.8 to 76.4 mm's or up to 25 times the amount of loose skin provided by non invasive techniques. That reality should always be front and center in the decision making for prospective neck lift and facelift patients. It should also be noted that non invasive techniques have no ability to properly dissect, elevate, trim and re-suture the SMAS or Platysma muscle layer making them one dimensional at best. Hope this helps.