This patient is a 63 year old retired RN who had thought about facial rejuvenation for some time. Although she had her upper and lower eyelids done some 25 years ago, she was now mostly concerned about her neck and jowls. She stated that she wanted a “jowl-ectomy.” She reported a history of having some migraines for which she took Imitrex. As Dr. Daniel was evaluating her, he reviewed that her brows were somewhat asymmetric, but also that they had settled lower on her forehead. As well, she had frown lines between her brows. Of particular importance to this patient, Dr. Daniel reviewed that endoscopic browlift surgery involves weakening of the frown muscles and this can significantly improve migraines. As such, the surgical recommendation for her was to undergo endoscopic browlift combined with a facelift and platysmaplasty (tightening of the deep neck muscle). As well, some fine lines to the upper lips were commented upon and 1cc of Belotero (injectable filler for fine lines) was also used at the time of her surgery. As you can see from her pre and postoperative photographs, a somewhat scowling, jowly appearance was noted preoperatively with redundant skin in the neck. Postoperative, Dr. Daniel and the patient were both happy with the improvement of volume in her mid-face, as well as improvements in her upper eyelids and symmetry and improvement in the frown lines. In addition, the jaw line is quite straight and the redundancy of the neck skin has been taken care of. This was all done without an unnatural over-pulled or over tightened look. Both Dr. Daniel and the patient were quite happy with her results. (The postoperative photographs were taken seven months after her surgery).