Study Objective: To assess the efficacy of hormone replacement therapy (HRT) in comprehensive rehabilitation after aesthetic surgery and develop an algorithm of clinical and hormonal monitoring.Design: Examination and follow-up of 92 patients after face and neck lift.Setting: Gynecology Department.Patients: Ninety-two women (ages 37-69 yrs) examined before face and neck lift and followed up for 18 months postoperatively.Measurements and Main Results: Preoperative clinical laboratory examination were complemented by assessment of hormonal profile, aging markers, oncology markers, bone resorption markers, lipoproteid fractions, coagulogram and also pelvic ultrasonography, oncocolpocytology, x-ray densitometry and mammography. Postoperative assessment by rehabilitation doctor included four parameters: extent of tissue edema, complications, sensitivity recovery and subjective facial assessment by patients. Each parameter was scored 1 to 5; the first two parameters had negative scores. The total score of 4 parameters was recorded for each patient at 1, 3 and 9 months. Three groups of patients were followed up: Group 1 (n=63) receiving HRT perioperatively; Group 2 (n=21) without HRT due to contraindications; Group 3 (n=8) not requiring HRT according to preoperative findings (controls). At month 1 parameters of all groups had similar scores (–7.3 to –7.9). At month 3 Groups 1 and 3 had higher scores than Group 2. At month 9 the difference in score between Groups 1 and 2 was 2.8. Group 1 had fewer subjective complaints and rehabilitation measures between months 3 and 9, while Group 2 complained of skin tightness and dryness, paresthesia and loss of sensitivity.Conclusion: The use of HRT in conjunction with aesthetic surgery is pathogenetically grounded. It reduces the extent of rehabilitation measures postoperatively and elevates subjective assessment of the results. Hormones are chosen individually, which reduces side effects. HRT is not limited to estrogen only. Adequate HRT is an important component of rehabilitation that helps maintain the achieved aesthetic results. Study Objective: To assess the efficacy of hormone replacement therapy (HRT) in comprehensive rehabilitation after aesthetic surgery and develop an algorithm of clinical and hormonal monitoring. Design: Examination and follow-up of 92 patients after face and neck lift. Setting: Gynecology Department. Patients: Ninety-two women (ages 37-69 yrs) examined before face and neck lift and followed up for 18 months postoperatively. Measurements and Main Results: Preoperative clinical laboratory examination were complemented by assessment of hormonal profile, aging markers, oncology markers, bone resorption markers, lipoproteid fractions, coagulogram and also pelvic ultrasonography, oncocolpocytology, x-ray densitometry and mammography. Postoperative assessment by rehabilitation doctor included four parameters: extent of tissue edema, complications, sensitivity recovery and subjective facial assessment by patients. Each parameter was scored 1 to 5; the first two parameters had negative scores. The total score of 4 parameters was recorded for each patient at 1, 3 and 9 months. Three groups of patients were followed up: Group 1 (n=63) receiving HRT perioperatively; Group 2 (n=21) without HRT due to contraindications; Group 3 (n=8) not requiring HRT according to preoperative findings (controls). At month 1 parameters of all groups had similar scores (–7.3 to –7.9). At month 3 Groups 1 and 3 had higher scores than Group 2. At month 9 the difference in score between Groups 1 and 2 was 2.8. Group 1 had fewer subjective complaints and rehabilitation measures between months 3 and 9, while Group 2 complained of skin tightness and dryness, paresthesia and loss of sensitivity. Conclusion: The use of HRT in conjunction with aesthetic surgery is pathogenetically grounded. It reduces the extent of rehabilitation measures postoperatively and elevates subjective assessment of the results. Hormones are chosen individually, which reduces side effects. HRT is not limited to estrogen only. Adequate HRT is an important component of rehabilitation that helps maintain the achieved aesthetic results.