BACKGROUND: Microfocused ultrasound (MFU) and ablative fractionated laser (AFL) resurfacing techniques have been used separately to noninvasively improve skin laxity and rhytides on the face and neck. Simultaneous combination treatment would be anticipated to provide further improvement but has not previously studied. METHODS: A retrospective analysis of 100 combination face and neck treatments from 3 centers was performed, including collective treatment protocols, postoperative recovery, side effect profile, and clinical results. RESULTS: Skin laxity and photodamage (rhytides and texture) showed significant improvement with combination MFU + AFL treatment. Except for increased facial swelling in a small percentage of patients, postoperative recovery and side effects were comparable with those obtained after application of individual treatments. CONCLUSION: Combination MFU-AFL on the face and neck is a safe and effective method for targeting multiple facets of facial and neck skin aging and can be safely performed in a single treatment session.