This is a 54 year-old lady who desired facial rejuvenation. She felt that she was starting to see typical signs of aging around her mouth and jawline. She also felt that her cheeks had lost fullness. She had been using fillers and Botox but was not able to get the desired results with these non-surgical options any longer. Therefore, she underwent a facelift with a rhytidectomy, SMAS elevation and plication, and platysmaplasty. A lower lid blepharoplasty was also performed to improve the puffiness under her eyes. Fat was also injected into her face to augment some of the tissue loss through the years.