I had consultations with three different surgeons on how to reduce my jowls, marionette lines, and the chording on my neck. All three recommended a modified facelift with facial fat grafting. One also recommended a modified Platysmalplasty while the two others felt it wasn't necessary. I would like feedback to find out if I would benefit from the modified Platysmalplasty procedure. I am 51.
I see this a lot in my practice. I feel that the best way to treat the bands in your neck (front edge of each platysma) would be a platysmaplasty. I don't see how any other technique would eradicate this issue. to your satisfaction.
Fat grafting can elevate the jowls a bit, but I find that addressing the jowls directly with a full neck lift (which includes the platysmaplasty) is best for the issue that you are describing.
Finally, if your cheek fat pads are falling, very common during aging, elevating them directly with a full-face lift will give a long-term result that cannot be mimicked with just fat grafting.
My suggestion would be to consult with a board-certified plastic surgeon that specializes in cosmetic surgery. The surgeon can see you in person and answer your questions more fully.
Thank you for sharing your question and photographs. I think you would absolutely need a platysmaplasty to get the best surgical results.
The medial cervical portion is difficult to resolve. As I don't work in the USA. A submental incision may be necessary and will work. I suggest you talk to patients who had surgery with the 3 surgeons and choose the one you trust.