This 62-year old lady was troubled by heavy jowls and a loss of neck contour. She underwent a combined deep neck reduction and extended deep plane facelift to create a youthful crisp jawline, eliminate the jowls and restore a youthful neck contour. In cases of a heavy lower face and neck, an extended release of the facial ligaments and reduction of deep tissues in the neck (submandibular glands) is key to achieving a major change. At 6 months, she was delighted with the natural look and new youthful contours.