Does firm thick skin not get as dramatic improvement from facelift as thin damaged skin would? (Photo)

you look like a great candidate for a facelift.  I would recommend seeing a few surgeons to get an in-person opinion from plastic surgeons known for their facelifts.  I suspect you will find a more positive response than during your last consultation. 

You should be able to achieve very significant improvement with a facelift.  I would consider your skin type to be quite favorable to achieve good results.Best wishes!Dr. Konstantin

Skin that is in good condition definitely yields a better result with a facelift. The skin in the photograph looks to be in good shape so I would expect the result of a facelift to be excellent.

I would classify your neck as a heavy neck with a obtuse cervical mental angle.    what this means is that there is excess adipose tissue or fat and that the hyoid bone which sits in the middle of the neck is more forward than on most other patients. Nevertheless excellent results can be achieved in the reducing the fat in the neck with either direct excision or liposuction,  and re-draping  the skin. Your skin appears to have good strength through it without significant loss of elasticity. You should do well with a face and neck lift. Consult a board-certified plastic surgeon to discuss your options. 

I agree that your skin is not the problem-it is actually just fine. You have a short distance from chin to hyoid bone which creates more of a problem in the neck. However, alot of people with your neck issues achieve excellent results with face and necklift in association with augmenting the chin (chin implant) and submental muscle repair and liposuction (conservative). Be optimistic.

 You can achieve a very nice improvement in your face and an even more significant improvement in your neck with defatting, muscle plication, and skin removal.Kenneth Hughes, MDLos Angeles, CA

Hello StillSouthern and thank you for this question which is important when seeking advice about a face or neck lift (or both).  I do believe you would attain a very good result with a standard two layer face and neck lift.  If you do have any excess fat under the chin, this could be removed at the same time with liposuction.  Fat injections to the face also provide even further improvement.Based on my 28 year experience, you will get a dramatic result and it will look natural if the procedure is properly performed by a plastic surgeon with experience.The most common question asked is: 'How long will my facelift last?'  The answer is different for everyone and does involve the quality of your skin.  Is there sun damage?  Is the patient a smoker?  How thin is there skin?Most facelifts last 8 to 12 years before another complete facelift is required for improvement.  However, I have seen some of my facelift patients results last longer and some less.  Necks seem to loosen a bit more than the cheeks.I hope this helps you and best of luck.

Dear StillSouthern:Thank you for providing your photos! They are helpful.Your skin does look lovely! Keep up the great work. Thicker skin, generally has more dermis and therefore will retain its resilience and longevity. Thinner skin will crease easier but is more easily redraped. Continued care, prevention, protection and stimulation of the turnover of cells and function will retain the face and neck lift investment. Your neck does not appear have lost height but
the loss of definition along the jawline and windpipe visually frames the neck
shorter. Various
options for facelifting are available according to the skin laxity, soft tissue
sagging and areas of lift or tightening you wish or need. 

Generally, a 2 layer facelift is performed under various names / variations of a similar technique. The more skin there is to remove and
tuck, the longer the incision. The more
soft-tissue and fat lifting required, the more skin (flap) needs to be elevated
in order to reach and suspend these tissues. 

The recent resurgence of the S-Lift (created in
the early 1900's), has been modified into a 2 layer lift and called by other
names as the Quick-Lift, Lifestyle-Lift, Swift-Lift, Soft-Lift, MACS-Lift and
others. They are a single modification of the S-lift targeted to elevate
sagging lower cheeks jowls and lateral upper neck. The shorter scar, limited
undermining and second layer lift achieve the "quicker" procedure but
not necessarily the quicker recovery or the improvements you desired.Jowling, a loss of the neck angle and jawline, fatty fullness and banding of the muscles are addressed with a 2 layer neck lift and if needed lipo-contouring.
Undermining the neck and placing a suspension suture across
the neck (with or without neck platysmaplasty) will help to suspend the soft
tissue descent of the neck and provide a crisper appearance. The platysmaplasty may be feminized (covering the thyroid cartilage and gland) or more masculinized (allowing for the "Adams apple" and thyroid gland to show). A chin implant or moving the chin bone forward will also help improve the neck angle and appearance. 

All of these concerns should be addressed  with a well experienced Board Certified Plastic
Surgeon or Facial ENT. I hope this was helpful! All the best!

 Patients with thick skin will usually have better results in the face than those with thin skin. In the neck however you have fullness under the jaw that would mean that you would not get as good a result as someone with a more prominent chin, longer neck and less submental fat. I think you can get a good result and you need to consult with a PS who can show you examples of what can be achieved in someone like yourself. It may be worth consulting with another PS if the results you see are not acceptable to you. 

You are a great candidate for an amazing facelift. You have beautiful well cared for skin and an attractive face. You could be an ideal facelift candidate. Your results should look very natural - be sure to view dozens of before and after images from multiple angles to be sure the plastic surgeon you select has demonstrated his ability to successfully perform the kind of result you want.  The other good news is that your skin quality will likely mean that the results of your facelift will last linger than those who have abused their skin in the past.You have an excellent starting point. Take your time choosing the right surgeon for you. You could end up looking great, but not like a person who has had a facelift .