As we age, the soft tissues of our face loosen and begin to descend, we loose volume (fat) in our face, and our skin begins to thin and become less elastic. In the mirror, we see loose, saggy skin, thick jowls, neckbands, and upper face hollowness. For younger patients that are not yet exhibiting these signs of aging, injectables and non-invasive skin tightening procedures such as skin peels are appropriate temporizing options. As we get older, however, excess skin begins to dominate the picture and non-invasive techniques become inadequate. Fortunately, the stigmata of ageing can be corrected with a neck and / or face-lift. These procedures can lift the soft tissue back into place, tighten the underlying muscle, and remove the excess saggy skin. The modern face and neck lift is a safe procedure easiest and most efficiently performed under general anesthesia. For the right patient, however, more limited procedures can be done under local anesthesia with sedation. See the link below for more info. A detailed examination will help delineate the best surgical option. Consultation with a surgeon certified by the American Board of Plastic Surgery would be the next best step.