The incision for a facelift usually begins behind the hairline in the region of the temple and runs in a natural skin fold directly in front of the ear, or close behind the cartilage at the front of the ear and then continues around the earlobe, behind the ear back into the hair.

In the case of tightening of the neck, an additional incision may be required under the chin. After the incision, the skin is detached from the fat and the underlying muscles.
The deeper lying layer of muscles and connective tissue is then mobilised and tightened upwards in order to lift the sunken muscle-fat areas again. Finally the skin is laid on top once again with slight tightening and the surplus is removed. 
The skin is then closed again in several layers, the incisions in the hair can also be closed using metal clips. A small drainage tube inserted under the skin drains off blood and secretion from the wound for approx. 12 – 24 hours. Finally a bandage is applied to the head in order to minimise swelling and discolouration in the region of the face.

A facelift can be carried out under either local anaesthetic or general anaesthetic. The form of narcosis your plastic surgeon selects depends on both the extent of the procedure and the form of narcosis you prefer.