I Hate my Neck

As you have already discovered, the minimally invasive procedures to tighten the neck are often disappointing. There are two excellent ways of reducing neck looseness.
First, a lower facelift can be done. This involves incisions behind the ear and underneath the earlobe. It tightens the neck and the neck skin nicely.
In some patients, the shape of your jawline contributes to the neck skin appearing loose. If the chin is receding, a small chin implant along with the lower facelift may be just the ticket.
A face lift that includes the upper and lower face can also redistribute volume, reducing it from the jowls and adding to the cheekbone area. This increases the power of the lift even more.
If cleverly done, performed by a oard certified plastic surgeon with a special interest and great experience in facelifts, facelift incisions should be minimally detectable or nondetectable. The ear and hairline should appear normal and unoperated.
For anesthesia, almost all modern facelifts use local anesthesia. Most patients in addition receive IV sedation or a light general anesthetic to make the procedure more pleasant. A properly selected patient should have a medical clearance and normal laboratory tests. If in addition the surgery is performed in an accredited surgical center with a board certified MD anesthesiologist, this will give the highest possible safety. We have all our facelift patients stay in an aftercare facility with a registered nurse at least one night after surgery, to monitor vital signs and keep the patient comfortable.
I have small children myself and many of my patients are very concerned with the safety of their surgery, especially if they have small children. Following all the guidelines above will not get you the best price, but will lead you to the safest surgery performed by the most competent surgeon.

Based on your photograph, an extended necklift or minifacelift may give you a great result.  These procedures can be performed under sedation or twilight anesthesia which is safer.  If you're not comfortable with that, a nonsurgical necklift is also a common procedure using fillers into the face to improve extra skin in the neck. 

You do not need to go under general anesthesia for a mini face and neck lift. This procedure cab easily performed with local anesthesia and twilight sedation. Laser surgery will not improve you neck laxity.

It is possible that you may be a candidate for what is termed, "The Laser Assisted Weekend Necklift:" It is a minimally invasive procedure. Cervicofacial Liposculpture is first employed to contour the unfavorable fatty changes seen in the face and neck as time passes by, such as the ‘Turkey neck’ and ‘double chin’.Careful attention is then turned to tightening the neck muscles and eliminating neck bands. Finally, I employ laser technology to ‘resurface’ the underside of the neck skin, thereby ‘shrinkwrapping’ the skin of the neck restoring a youthful contour.A consultation with a board certified facial plastic surgeon or board certified plastic surgeon will help determine which procedures will provide the best results for you.

I encourage women to undergo an Ultherapy UltraLift for the neck in order to tighten the muscles of the neck without surgery. Raffy Karamanoukian MD FACSLos Angeles Plastic Surgeon

From the picture you have shown, it appears that a straightforward neck lift concentrating on bringing your neck muscles back together can achieve the appearance you desire. This can be done under local anesthesia and you would eliminate the risks of undergoing general anesthesia. A midline plastysmaplasty or re-approximation of the neck muscles is performed with a small incision under the skin.