This is a facelift and neck lift case performed on a 68-year-old woman using the SMAS technique. The SMAS approach works at two levels: skin and the deeper muscular layer beneath it. Repositioning that deeper layer is what allows the surgeon to address the lower face and neck without relying on skin tension alone. What you're seeing in the after photo was taken six months post-op, when swelling has fully resolved and the tissues have settled into their final position. The jawline and neck contour visible in the second image reflect where the SMAS repositioning directed the tissue. Six months out is a reliable point at which to assess a facelift result.