This 64 year-old lady underwent a deep plane facelift and deep neck reduction to address a heavy lower face and severe tissue laxity in the neck. A combination of suspension of the deep tissues of the face (SMAS and platysma) as well as a reduction in deep tissue structures (buccal fat pad, submandibular glands, anterior belly digastric, deep fat) was required to achieve such a dramatic result. Result at 8 months.