This vigorous gentleman wished to improve the appearance of his neck, face, and lower eyelids.  

He underwent two layered facelift. A thoroughly performed SMAS (superficial musculoaponeurotic system) flap was raised to suspend the deep layer soft tissue of the cheek and the jaw area in addition to the skin lift.  The surgical incision was placed next to the temporal hairline to avoid displacement of the temporal hair. 

Improvement of the neck was accomplished through skin reduction and modification and suspension of the neck muscle layer. An incision under the chin was used for the neck lift.