The development of aesthetic surgery as a major segment of plastic and reconstructive surgery is accepted among physicians. From a procedure at one time limited to the few, aesthetic surgery of the aging face has become commonplace. The patient seeking aesthetic surgery is attempting to improve self-image. The three major factors necessary for successful results are proper patient selection, a careful preoperative psychological evaluation, and expertise in carrying out the surgical procedure including management of complications. A total preoperative evaluation is essential to individualize the appropriate procedure which is correct for the particular patient.