This patient has ageing changes related to her face and neck. It is important to discuss the pros and cons of addressing the neck at the same time as the lower face. There are a number of options depending on what is needed. Tightening of the neck involves mobilisation of the neck muscle called the platysma and separation of this from the skin and underlying surfaces. Release of the muscle allows it to be drawn back towards the ear and rejuvenates the neck. It can be tight afterwards but often settles in a matter of days.