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Facial aging is a combination of descent of facial tissues, atrophy of fat compartments, bony remodeling, and chronological and photoaging changes of the skin. A rhytidectomy will address the aging changes due to gravity on facial tissues but will do little to improve skin texture, thickness, and pigmentation. To address collagen loss, rhytids, and dyspigmentation, surgeons are incorporating resurfacing techniques including carbon dioxide/erbium ablative and fractionated lasers, 35% trichloroacetic acid chemical peel pretreated with Jessner's solution, phenol 88% chemical peel, Baker's solution chemical peel, and dermabrasion. More recently, surgeons are approaching facial aging with a more comprehensive approach to address both gravity and collagen changes by a combination of rhytidectomy with resurfacing. Technique and modality selection are keys to maximum single treatment results and therefore the greatest patient satisfaction.