This late 50's gentleman was reluctant to come in to a plastic surgeon's office since he felt that plastic surgery was effeminate and not meant for older "straight" men. However, at his wife's insistence, he did come in and upon gentle prodding revealed he did not like the way he was aging. Specifically, he disliked his jowls, tired eyes and loose neck. He obviously wanted to look natural without having to adjust the way he presented himself to others. Being one of the premier facelift specialists in Beverly Hills and indeed, the US, Dr Haworth formulated a customized surgical plan including bilateral lower blepharoplasty with fat transfer to his hollows, a modified classic facelift (rhytidoplasty or rhytidectomy) with an extended neck lift. Most traditional facelifts (whether they be a SMAS, extended SMAS, high SMAS, SMASectomy, deep plane, composite, etc.) should include a neck lift of some sorts. The patient also wanted his protruding ears corrected "while he was under" since they always bothered him. Dr Haworth performed the facelift, lower eye lift (blepharoplasty) and otoplasty (ear pinning) and his 6 month follow up is presented. Like most facelift specialists, Dr Haworth placed a drain for the first night after surgery.