Options to Correct a Sagging, Wrinkling Double Chin?

The neck is one of the more complex areas to deal with in terms of aging. Several factors contribute to facial aging involving the neck. Skin laxity, excess fat, and weakening of the muscles and supporting structures of the neck are three of the more common reasons.
A small chin that you may have had your entire life may also contribute to the sagging in your neck that you are now seeing. Diet and exercise are essential, but, only helpful to a point. A thorough evaluation of your neck and face by an experienced physician will enable you to receive the best advice for your particular situation.
One procedure or approach is definitely not appropriate for all patients. A combination including surgery to address the skin and muscles of the neck and liposuction will likely be required at 59 years of age.

Neck rejuvenation is a specialty unto itself. When I counsel patients about improving the neck area I make sure that they understand that the neck has several layers that need to be individually addressed to optimal improvement. The first and, in my opinion, the most important layer, is the skin. Taking care of your skin will make the best statement about you in the end. To this end, I usually recommend healthy water intake, sunscreen with an SPF>30, and medical grade skin care product usage.
In my practice I further improve the skin through the use of laser skin resurfacing and prefer to use Active FX fractional carbon dioxide laser to gently tighten the skin over the course of 3-4 treatments. The next layer to consider is the fat layer directly under the skin. The best way to deal with it is to perform small cannula liposuction.
I use VASER ultrasound technology to try and get some additional skin tightening with the loss of the fat. It is not absolutely necessary though. The final layer to consider is the underlying muscle layer known as the platysma. The platysma muscle with time and use become loose and starts to sag. Here in Denver, women are extremely active with yoga and Pilates.
Those disciplines require some unusual head positions that stretch those neck muscle out and, in my opinion, contribute to sag. A neck lift procedure helps tighten the underlying muscle layer and gets rid of excess old skin to give you better definition to your neck. Hope this helps.
Dr. Shah