Sagging jowls and neck lines at 34, will laser tightening work or do I need surgery for a youthful lift? (photo)

Might consider "PRECISION SMART LIPO LIFT", ThermiTight RF Lift, Fat grafts or Voluma fillers, and finally a mini facelift. Or combination of all three... 

You have a beautiful and elegant jawline and I sure wouldn't be thinking about surgery at this point. I would see Dr. Cynthia Mizgala or Dr. Von Graham right there in New Orleans and let someone put a little botox in your neck since this is most likely due to platysmal banding. Both of them are very experienced and excellent. Dr. Mizgala was the gold medalist in Surgery in Canada which is the award given to the top surgical resident in the nation when she trained at McGill university and was number one in her class every year of her life from grade school through medical school! I was her boss at Ochsner when she was right out of residency and she is outstanding as a person and a doctor. Dr. Graham was also in my department when I was there before Dr. Mizgala came to join us and he did a facelift on my mother if that tells you what I think of him. You can't go wrong with either one.  Also there are now some great noninvasive techniques for giving you back a little facial volume as well as some skin tightening. I use sculptra, Voluma, and Juvederm HC depending on the issue. Unfortunately a lot of nonsurgeons use that stuff too and it looks bizarre so be sure to go to a surgeon for injectables.  Also you need to consider doing some Sciton microlaser peels to keep your skin looking good.  Also you might want to check into a program called "Forever Young BBL" which is a program where Exilis and BBL is used to tighten skin and also prevent aging. Studies out of Stanford with a 12 year study show BBL can actually cause genes in the skin to express younger with one to two BBL's per year. I would say you are a good 10 years away from even just a mini-lift. Stay out of the sun or use great sunscreen too.  Hope this helps.