This is a common question and many surgeons offer either/or. This shows an inexpert understanding of the anatomy of facial descent and usually caters to what patient’s ask for not what they need. The face and neck should be thought of as one unit (because they are) and should be rejuvenated together for a natural balanced rejuvenation. A tight neck with jowls is as unattractive as a tight jawline and sagging neck. See May’s case as an example.