Facial aging procedures should be customized both to the changes that are visible and to the desires of the patient. In some cases, several options may be suitable to satisfy the goals of the patient. A detailed conversation between the plastic surgeon and the patient enabling shared decision making helps to maximize the likelihood of a satisfactory treatment outcome.

This case illustrates a treatment decision that involved shared decision making regarding the concerns of a 50 year old patient with facial aging. During the initial consultation, she stressed that the most worrisome aspect of her appearance was her sagging neck. Although aging changes of the face were of concern, her desire for a more limited procedure focusing on the neck was clear. We decided together that a neck lift would be performed and the outcome at 1 month is seen below. The patient was very pleased with the improvement and was gratified that she was able to achieve this result with neck surgery alone.