Using the 2005 Caprini RAM, this patient has a risk score of around 5 (2 points for age, 2 points for history of malignancy, and 1 point for history of varicose veins). General anesthesia has been shown to increase the risk of venous thromboembolism (VTE), likely primarily due to loss of muscle tone in the posterior compartment of the lower leg and subsequent venous stasis. Procedures under IV sedation have a lower risk of VTE. Facelift, necklift, and blepharoplasty can all be performed under sedation with good local anesthesia. The use of perioperative chemoprophylaxis has been shown to decrease the rate of VTE. However, the use of preoperative or intraoperative chemoprophylaxis has been shown to significantly increase the risk of bleeding in facelift surgery as well as body contouring surgery. Although increased operative time has been shown to raise the risk of VTE, elevating a superficial musculoaponeurotic system(SMAS) flap is unlikely to add a significantamount of operative time to the case and is an important component for achieving and maintaining long-term facial rejuvenation. When performed efficiently, all three components of this case should be accomplished in under 6 hours, a time limit recommended by the American Society of Plastic Surgeons (ASPS).