A 57-year-old patient who was referred by another doctor. She lost 100 pounds and, as a result, has a lot of sagging in her facial tissue. She also has deep creases in her face and brown spots from sun damage. She is not happy with the sagging of her face and neck. The procedures she selected are a rhytidectomy (facelift) plus a 30 percent TCA chemical peel, a coronal forehead lift, and perioral dermabrasion. The after picture is one year after surgery. Pay particular attention to her neck “bands,” which are dramatically better. Also the volume of her face is improved—and NOT from fillers or fat.