The procedure often begins with an incision at the temples, just above the ear, that extends along the inside of the scalp in front of the ear to behind the earlobe. For work in the neck region, an incision is made under the chin. Many procedures can be performed endoscopically through 5 or 6 tiny incisions instead of a linear incision.
After the incisions are made, the skin is separated from the muscle and fatty tissue. Excess fat is trimmed, and the surgeon shifts and tightens the underlying muscle and tissue. Skin is then pulled and sutured back into place.