This 72 year old female with history of two previous facelifts and facial CO2 treatment presented to the office with concerns for jowl and cervical laxity and facial rhytids. She was interested in both surgical and non-surgical options for treatment. Examination demonstrated coarse rhytids in the perioral area and cheeks as well as fine rhytids in the forehead and periorbital region. There was significant jowling and cervical laxity with wide but prominent platysmal banding. Addtionally, there was generalized volume deficiency of the lower two thirds of the face. To address her concerns, she underwent a deep plane lower facelift with platysmaplasty, lower two thirds face fat transfer, and full face fractionated matrix CO2 laser at 95%. By her three-month follow-up, the patient had achieved an excellent result with a smooth neck and jawline contour and significant improvement in her facial rhytids and volume deficiency. Her refreshed, youthful appearance is best accentuated in the profile and frontal views.
