In general, Cosmetic surgeon separates the skin from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. Surgeon then tightens the underlying muscle and tissue, pulls the skin back, and removes the excess. Stitches secure the layers of tissue and close the incisions; metal clips may be used on the scalp.

Following surgery, a small, thin tube is temporarily placed under the skin behind your ear to drain fluids that might collect there. Surgeon will also wrap your head loosely in bandages to minimize bruising and swelling.
A facelift can be performed on an outpatient basis in a hospital, ambulatory surgical facility or office-based surgical setting. However, in some cases, your facelift surgeon may recommend an overnight stay in a special care facility or hospital may. Usually, facelifts are performed under general anesthesia, though local anesthesia with sedation may be used in some cases. Facelifts are performed by board-certified plastic surgeons and facial plastic surgeons.
There are many facelift techniques available today that address different problems. A facelift surgery is a procedure that is tailored to each patient's specific needs and may include a browlift, eyelid surgery, as well as laser skin resurfacing. In some cases the facelift procedure may also include the neck area in order to give the patient better results. In addition, fat may be added to certain areas of the face to restore loss volume and refine results.  

A facelift begins with carefully placed incisions. These incisions are made in most cases just inside the hairline at the temple, extending down along the natural curve of the ear, back behind the ear and horizontally into the hairline. These scars are position behind the hairline in order to help hide them although they are not very noticeable.

The incisions made during your facelift surgery take into account your natural hairline and any sideburn pattern. A shorter or limited incision is possible in cases where a full facelift is not necessary and excess skin in the jowls or neck is minimal. In a limited incision facelift, your facelift surgeon will analyze the rates of aging over the different areas of your face and place the incisions where you need them.
Facelift incisions allow the plastic surgeon to visualize the underlying facial structure and fat as well as to reposition muscle and redistribute fat during facelift surgery.

face lift surgeryAfter the incisions are made, the facelift surgeon will then proceed to reshape and sculpt the face. The facelift surgeon will then return muscles to their original position and restore fat to where it has diminished. In some cases the neck may be addressed during a facelift. Through an often very small incision concealed underneath the chin, your facelift surgeon will manipulated vertical bands in the neck, just beneath the chin, for a smoothing and complete effect. If necessary, fat pockets are also corrected during this step in the facelift surgery.
The final step in the facelift surgery is to drape the skin over the new foundation, to reduce the excess skin and close the incisions. The facelift incisions are closed with stitches or staples and in some cases with skin adhesives.
It is very important that your facelift surgeon only removes the right amount of excess skin. Even with the best underlying facelift technique, if too much skin is reduced the results can be an unnatural and tight look.