Patients may be instructed to shampoo their hair the night before surgery, and a small amount of hair at the temples or around the ears may be shaved. The surgery can be performed in a physician's office, an outpatient surgical facility or a hospital, depending upon the physician's and patient's preference. It can be done under general anesthesia with the patient asleep or local anesthesia in which the area is numbed and the patient remains awake. Premedication is usually administered to relax the patient. In the basic procedure, the surgeon works on one side of the face at a time.
Loose skin is separated from underlying tissue and is pulled up and back and excess skin is removed.
Connective tissue and sagging muscles are tightened, and in some cases, fat deposits are removed from beneath the chin arid neck. This may necessitate an additional small incision under the chin. Tiny sutures are used to close the incisions. A rhytidectomy may take from three to five hours or more depending on whether other procedures are done at the same time. After surgery, loose bandages which are applied to the area are removed within a few days.