As a cosmetic oculofacial plastic surgeon practicing in Manhattan and Long Island for over 20 years, I do a lot of facelifts, neck lifts and neck liposuctions and even facial implants including chin and submalar cheek implants. A necklift is a procedure with an incision that is made slightly in front and behind of the ear to lift excess, redundant and sagging skin and to also deal with platysmal bands. The muscle that is underneath the skin contributes to the appearance of bands and sagging skin, so a necklift is the procedure for that type situation. I would first evaluate and see if you have extra skin or if it is a manifestation of other anatomic issues related to the hyoid bone. The hyoid bone defines the neck angle: for some it’s low and forward or high and back. The hyoid bone is important in determining whether or not a lift will help you. If you’re hyoid bone is very low or it’s very forward, then you have a very short distance between the bone and the chin, so when you pull up the skin you don't get much differentiation. This is important for people who have facial aging because there is a downward decent of migration of the hyoid bone. In a consultation, I typically lift the skin to show the patient their maximal potential benefit. The choice of a chin implant or adding projection to the chin is also not a straightforward procedure. The chin may be back because it is relatively short, or there is a misalignment in the position of the mandible or the jaw bone relative to the upper jaw bone composed of the mandible and the maxilla. Sometimes, people have the perception of a weak chin because their teeth are relatively misaligned. By doing a simple examination in the mouth, you can see if someone has a relative overbite and the chin is posterior. If that’s the case, if they were to get a chin implant, they would get deepening of an area called the labial-mental crease which is a crease between the lip and the chin. In some people, it can be adjusted and the chin implant can be positioned. Patients should choose a size that would fit the face if they’re not interested in doing some kind of oral-maxilla type of procedure. In your situation, you might be a candidate for a chin implant. You may also want to consider neck liposuction. This procedure reduces fat along the under part of the jawline as well as below the chin if there’s extra fat. However, we also have to be conscious of not taking too much fat away. Most of the time, plastic surgeons are very aggressive about removing fat. I have had patients who needed to get fat transfers to restore the fat or I did something to rehabilitate the skin. The thin layer of fat under the skin makes skin look youthful. Last issue is your physical weight - if a younger person is over 10 pounds their ideal body weight, then a simple weight loss can actually help define the jawline and the neck. I suggest that you have a physical examination with qualified, experienced cosmetic surgeons and explore your options. The photo is helpful but to make a recommendation that is definitive would require an examination. Anatomic features such as the position of the hyoid bone, physical weight, the position of your mandible relative to the maxilla in terms of your bite or if you have an underbite or a normal bite are all factors before making this decision. I hope that was helpful, I wish you the best of luck, and thank you for your question. This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.