Rhytidectomy remains a challenging surgical procedure for even the most experienced aesthetic plastic surgeons. The challenges are compounded by complications that are inherent to this procedure and place added pressure on the doctor-patient relationship. Expectations for both parties are high and the margin for error nil. This article presents a personal approach to the avoidance and management of complications associated with facelift surgery. It presents the author’s personal approach as a plastic surgeon in the practice of aesthetic plastic surgery over the past 25 years. Clinical pearls are provided to obtain optimum results in rhytidectomy and limit associated sequelae.