Saggy face at 42 with deep marionette lines, jowls, NL folds, and turkey neck. What is the best solution? I lost 50lbs. (photo)

Based on your photos, I would suggest researching and discussing a facelift, neck lift, volume replacement with fat transfer, and laser skin resurfacing.  During your consultation, your board certified facial plastic surgeon should be able to help you understand your aging process and whether or not these procedures will help you achieve your desired results.  Facial Rejuvenation is as much medical as it is art. Make sure to see someone who performs these procedures at least on a weekly basis. All of these procedures can be safely performed under local anesthesia. 

Great question and thank you for your photos.  As I'm sure you could guess, the solution to the loose skin and muscle around your lower face and neck is to lift and tighten those tissues.  The procedure, done properly, should address your concerns.  Most notably, the jowls and neck will be helped the most.  Nasolabial folds sometimes require additional procedures or injectable fillers, but the vast majority of patients with your particular set of issues are happy after a properly done modified deep plane SMAS facelift.
The procedure as an easy recovery and most people are back to work and regular life within 10-14 days.
Don't be too concerned about your age.  If you have the laxity, like from the weight loss and/or genetic factors, the facelift is the gold standard treatment.
A complete examination during consultation would also give you the opportunity to ask more questions as well as provide you with additional options for your best outcome.
I hope this helps, I wish you all the best!

Thank you for your question and the photos- they are very helpful. First of all, congratulations on your weight loss- that is such a major accomplishment. At this point I think you are a great candidate for a lower face and neck lift. Your skin texture and tone looks very youthful and I think you would do well with the lift. Make sure you visit a surgeon who specializes in facelifts and someone who will tighten not only your skin, but the supporting structures underneath. You will also want your neck muscles addressed. Hope this helps!

Congratulations on the weight loss and getting healthier and being medically optimized! Usually when there is excess skin from weight loss, removing that skin is the best option.There are various combinations from a mini facelift, mid facelift, and neck lift that can address different areas. There are never any guarantees of course with any procedure whether it is surgical or nonsurgical in nature.
Surgery is not for everyone. In today's day and age, there are many nonsurgical options to consider although surgery usually gets the most improvement specifically of the jowls.
I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of facelifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations. 
I hope this helps and wish you all the best in your surgery and event. If it does, please take a moment to up vote this answer on the “respond” button on the top right. 

Many thanks for your question and photographs.As you are aware, there are many variations in facelift technique. The fundamental target of all facelifts, however, is addressing the SMAS - the soft tissue framework of the face that is deep to the skin.There are many ways of addressing the SMAS, and every surgeon will have their preference. The key is that it is adequately addressed and that the skin is then gently trimmed and neatly stitched to give you the best, most natural appearing results.Good luck in taking things forwards

Thank you for your question and photographs. The "best" option will vary for patients. Fillers can help add volume to hide the marionette lines, smile lines, and nasolabial folds. For younger patients in the their 40's who aren't ready for surgery, this can be an appropriate option. Based on photographs alone, one may consider surgery such as a facelift with cheek lift, neck lift, neck liposuction, and fat transfer. Lastly, the lower face, jowls, and neck may also be improved with chin augmentation in appropriate patients. If you haven't already, then speak with a plastic surgeon to review options appropriate for you.Best,Dr. Chaboki

The most long lasting solutions are always surgical ones, if you are open to them, for the jowls and neck.  The marionettes can be improved with filler injections.  Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search. 

So happy you were able to lose the 50 lbs!  That is terrific news and very important to your overall health and well being.It is true that sometimes with that kind of weight change one can end up with a sagging neck and jowls.  The best solution is going to be some kind of facelift procedure.  I happen to be in favor of a lamellar SMAS lift because it gives me the power to enhance the mid face while without creating a "Pulled" look.  I've done it for a lot of my bariatric (weight loss) patients.Good Luck!

Hi,Congratulations on the big weight loss. As you have mentioned, a facelift is going to be your best treatment option. The most important determinant of the longevity of a facelift is the type of facelift performed and the skill with which that facelift is performed. There are many skin tightening procedures that are advertised as facelifts but fail within a year or 2 because the skin is not designed to maintain tension and will weaken and stretch immediately after surgery. A true facelift involves identifying and isolating a dense layer of tissue under the skin called the SMAS and using the SMAS to hold the tension of the facelift. An even more durable surgery is the deep plane facelift which involves dissection under the SMAS to give more mobility and lift to the sagging tissues of the face and neck. The logical questions is “why don’t all surgeons use this technique?” A deep place facelift is more challenging, takes longer to perform and has a longer recovery period but the results are the most natural and can last in excess of 10 years. I recommend an evaluation by a facial plastic surgeon to discuss all the details of a deep place facelift. Best,Mehdi Sina, MD

Hello and thank you for your question. Based on your photograph, you may
benefit from a mini facelift with a neck lift.  If good technique is used,
this can be done with minimal scarring and can result in a natural look, not
over-done look, with rejuvenation of your face.  Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results. The most important aspect
is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon