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This 54-year-old woman came to me with interest in having a revision facelift surgery a few years after her first procedure to target sagging around the mouth and jawline, as well as concerns regarding a thinner and longer upper lip that she felt contributed to her aged appearance. She had developed a pixie ear deformity of the ears from excessive pull from the original facelift procedure. This was corrected by reconnecting the ear lobes in a more natural position. During the procedure, a mastoid fascia graft was obtained to augment the lips. The upper lip was also lifted via a subnasal lip lift with the incision placed right under the nose.

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