Yes, there are certainly options for patients that are not healthy enough to undergo general anesthesia specifically regarding their lower face. Standard facelifts or certainly extended SMAS deep place facelifts are typically performed in the operating room setting under either deep sedation or general anesthesia. Options for patients that are not healthy enough to undergo these types of anesthetic care would be mini facelifts, which can be performed under local anesthesia in the office and I have certainly performed these on patients that are not qualified for procedures performed in an operating room setting. Though this treatment is compromised compared to the more sophisticated and technically demanding extended SMAS deep plane facelift, they nonetheless get a very significant improvement in the lower third of their face and these patients are quite satisfied with the results of this type of surgery. A more advanced and newer technology that is available now for patient that are showing the early signs of aging would be Ultherapy, which is an ultrasound device that can target the deeper layers of the skin and this ultrasound energy is then focused on the deeper layers thus heating up the collagen and causing new collagen deposition, which in turn results in tightening of the deeper tissue and lifting of the facial structures. This can be performed in the area around the eyes to cause a nonsurgical brow lift. This can also be used to treat the midface, jowl, and the area under the chin to create the lift of a miniature facelift. There is no need for any anesthetic and there is absolutely no downtime as this is performed in a medical spa setting and the patient’s own healing creates the lift over a three-month period. This would be an excellent alternative for any patient with early aging that is not a good candidate for a standard facelift.