Aging happens to the best of us, and many patients believe that s facelift will solve all their perceived problems and make them look like they did 20+ years ago. If that is a patient’s expectation, it is incorrect and must be reframed to be realistic. Our faces can age in three distinct ways, which may require more than one approach to have a complete facial restoration. Good old gravity works affects the facial skin, pulling it down causing it to droop. This is where the facelift intervenes and corrects what gravity has done over the years. Next, the skin on the face ages, and as a result develops uneven tone, dark spots, enlarged pores, and loses the youthful skin glow. Because a facelift works on the underlying structure of the face, it does not address the skin’s quality. However, that does not mean there is not help. Laser treatments can very well address these surface skin issues to eradicate uneven skin tone and brown spots. Skin resurfacing can also help the skin tone. Finally, there is skin laxity caused by natural reduction in the skin’s volume. Though a facelift will tighten things up it cannot correct issues with skin volume. This is where dermal fillers, fat grafting and/or cheek and chin implants come in to play. Though dermal fillers are not permanent, they can last for long periods of time before revision is required. Implants for the cheeks and chin are permanent. The facelift is a tried and true tool for plastic surgeons, but like any procedure, it does have limitations. Nevertheless, skilled plastic surgeons such as Houston’s Michael Eisemann, M.D. know how to blend different tools and procedures to provide patients with the look they desire.