Without examining you in person, it is impossible to say which procedure would be best for you. But no, a facelift is not the only option. However, it may very well be the best option. With severe to moderate sagging in the skin, the patient must weigh the pros and cons of surgery. A facelift gives me the most access to lift the skin and tissues of the face in order to deliver a natural and more youthful look. But some patients just don’t want surgery. For them, non-surgical procedures with RF and microneedling can definitely deliver some skin tightening. It’s just important to keep in mind that this result will never rival what you can get from surgery.