How it works
First, you are examined and counseled by a plastic and aesthetic surgeon, who is also the same person who will perform your surgery. The surgeon assesses your general health, the shape of your face, the nerves of the face, and how much the skin and muscle have sagged. You also have routine pre-operative tests and are seen by the anesthesiologist.
There are two ways to manage comfort, depending on your situation: general anesthesia, or local anesthesia combined with sedation (medicine that helps you relax and feel less anxious). Your surgeon will talk it through with you to choose what suits you.
The incision usually follows the hairline at the temple or sits fully within the hair-bearing scalp, then runs along the edge of the ear and curves around behind it. Placing the incision this way helps keep the scar more discreet. Your surgeon may work on the skin layer alone, or also tighten the soft-tissue layer underneath (the SMAS and platysma, the muscle-and-fascia layer that supports the face and neck). Tightening the deeper layer is more involved and takes more time, but it gives a more natural result that holds longer.
If you have excess skin and fat on the eyelids, your surgeon may combine removing the extra skin and the eyelid fat pads during the same operation. Depending on the surgeon's practice, a small drain may be placed in the incision to let fluid escape, usually removed within 24 hours. The surgery takes about 2 hours.