Hello CJT875362. Thank you for your question regarding the best surgical options to address jowling and slack neck skin, concerns that you've noted are genetically predisposed in your family. Based on your description and the photo provided, the most effective solution for rejuvenating your aging face would be a combined approach of a facelift (rhytidectomy) and a neck lift (platysmaplasty). This comprehensive strategy will address both the lower face and the neck, providing a harmonious and youthful appearance. Types of Facelifts: SMAS Lift: This is the most recommended type for your needs. The Superficial Musculo-Aponeurotic System (SMAS) lift involves repositioning and tightening the deeper layers of the skin and muscle, providing more durable results. It effectively lifts the jowls and restores definition to the facial contours. Skin-Only Lift: While less invasive, this type tends to have shorter-lasting results and is less effective in addressing more significant signs of aging. Deep Plane Lift: This more extensive procedure addresses the SMAS and deeper structures, ideal for those with severe sagging but may come with a longer recovery period. Platysmaplasty: Alongside the facelift, a platysmaplasty involves tightening the platysma muscle in the neck through a small incision under the chin. This procedure corrects the appearance of a "turkey neck" by redefining the neck's angle and smoothing out the skin. Procedure Details: Facelift Incision: The incision typically begins in the hairline at the temples, continues around the ear, and ends in the lower scalp. This placement allows the scars to be well-concealed. Platysma Technique: Tightening the platysma muscle not only improves the neck contour but also enhances the overall result of the facelift by providing additional support to the lower face. Given your age and the description of your skin's laxity, undertaking these procedures sooner rather than later will allow you to enjoy the rejuvenating effects for many years, potentially preventing the need for further interventions as you age. Consulting with a board-certified plastic surgeon who specializes in facial aesthetics will enable you to get a personalized evaluation and ensure that the chosen procedures are tailored to meet your aesthetic goals effectively. I hope this response clarifies your options for a neck and face lift and helps guide your decision toward achieving the best possible outcomes. Good luck, and may your surgical journey be both successful and satisfying. Sincerely, J. Timothy Katzen, MD, FASMBS, FICS Plastic and Aesthetic Surgeon