This is a 69 year old patient that had a previous full face/neck lift elsewhere 16 years ago, she now presented with facial aging, recurrent jowling, malar descent and cheek laxity and platysmal banding in the neck. She underwent an in-office face/neck lift revision with local anesthesia and po valium only. Tightening of the deep plane and lateral platysmal (muscle) was performed to improve the banding, jowling and cheek and jawline. Very little skin was removed. She also underwent micro and nano fat injections at the same time to the deep malar fat pad (medial cheek) and around the mouth for lip lines and volume loss. 6 week photos are shown above with significant improvement.