This is a 54-year-old, male resident of San Francisco who presented to the San Francisco office at Union Square for evaluation of his aging face. He underwent an eyebrow lift and lower lid eyelid lift with a lower facelift. He had buccal fat excision, or cheek fat excision, of his cheeks and he also had 7 cc of fat injected into his right and left upper cheek. He underwent a prejowl chin implant. His goal was to have an overall more youthful appearance. The lower facelift included a SMASectomy excision, which is excision of the deep tissue to thin his face as opposed to a SMAS plication, which would give more volume to his face. He had liposuction in the jowl region and a complete platysma transection in his neck. He had the eyebrow lift with 11-millimeter elevation bilaterally. His procedure was performed at Marin Cosmetic Surgery Center in Marin County, California. Note the herniated cheek fat that has caused a significant fullness in the jowl location.