INTRODUCTION As populations expand and life expectancy increases, growing numbers of people are seeking methods to reverse the outward effects of ageing. Over the past decades, refinements in surgical techniques have enhanced our ability to achieve natural-looking results with an emphasis on facial harmony and avoidance of the stigmatized ‘operated’ look. This has allowed aesthetic facial surgeons to meet the high expectations of an increasingly astute patient population and permitted the practice to flourish. Central to the discussion on ageing face surgery is the evolution of facelift surgery, or rhytidectomy. This chapter will provide an overview of the history of facelift surgery and its techniques, and review the senior author’s approach to ageing face surgery. The recent resurgence in interest in autologous fat grafting will also be reviewed.