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Before

After

Before

After

Before

After

Before

After

Before

After

Before

After

Before

After

This patient of mine was troubled by loss of volume and facial sagging associated with ageing but accelerated by the menopause. She particularly disliked the deep folds in the lower face (jowls and marionette lines) and feeling as if she looked sad the whole time. She underwent a combined extended deep plane facelift and deep neck reduction with fat grafting. Reducing the submandibular glands (and not fat removal) was a key part of achieving such a dramatic change in the neck contour. At 2 months, she was thrilled with the change and renewed confidence.