I had a facelift to tighten neck in 2009, but the skin is loose again and not matching my face. Do I have any options?

Thanks for your question. As you've
already discovered, the results of facelift surgery are not permanent -- but
it's wonderful that you enjoyed 7 years of results! Without a photo or
in-person consultation, it's impossible to know exactly which procedures would
best suit you. However, keep in mind that most neck lift procedures don't
require a scar at the back of the neck. Instead, they're typically rather small
and made beneath the chin. Please seek out a board-certified plastic surgeon
near you to learn more about your options.

Without seeing you in person it is impossible to
determine what procedure would best help you. That being said, there may be a
few options available. At my practice I perform what I call a “mini-lift” on
appropriate candidates who are showing early signs of skin laxity, but who do
not yet have heavy jowls or turkey neck. This surgery can be performed while
the patient is awake. This procedure is
minimally invasive, with fewer incisions (and therefore less scarring) required
than a full facelift. Another option may be a non-invasive skin tightening
treatment such as the Titan laser or Ultherapy. These treatments do not require
any incisions or downtime, but be warned that the effects are less dramatic
than can be achieved through surgery.

I
understand your reluctance to undergo another full facelift. Given the issues
you've brought up, a neck lift may be an appropriate way to reverse the loose skin
in the neck. However, it's also possible that you may need another facelift
after all (likely less extensive than the first) to achieve the results you're
looking for. Incisions should not dissuade you from either option, because they
should be very minimal and difficult to see once they heal. I think
the best course of action would be to sit down with a board-certified plastic
surgeon and explain your current situation. He or she could judge which
procedure would make the most sense in your particular case. Best wishes.