The neck lift is great, it's like it was when I was 20, and with no swelling, no pain, no infection. However, I signed papers for a neck AND jowl lift and was shown by the doctor, with a woman staff member present, how the results would look. The results would leave me without jowls and also eliminate marionette lines. I had told the doctor how people would say to me, "smile", thinking I was frowning, when my face was just at repose. It was those marionette lines making me look unhappy. Of course people had no business doing this. After the operation, I asked him when the jowls would be addressed. He just kept saying we have to wait for healing. Now, at more than 6 months post-op, he lead me to believe he would address this soon, saying he'd call me in a week. At 2 weeks, I called the office because I'd not received his call. Office staff woman said that he'd be sending me a letter. 2 more weeks, no letter. Now I'm looking at small claims court procedures. I have to talk with him again to see what can work. At this point I have not confidence in him. Communication with patients about outcomes seems lacking. We as patients don't know all the questions to ask. This doctor with 20+ years experience and who volunteers his stills outside the U.S.A., should do better with communication.