In composite rhytidectomy, all of the deep aging anatomic components of the midface are elevated in the skin flap. The platysma muscle, cheek fat, and orbicularis oculi muscle are repositioned in this bipedicled musculocutaneous flap, which very effectively improves the nasolabial fold. Repositioning of all of the deep elements of the aging face and forehead is obligatory in creating a harmonious rejuvenation.