A facelift operation has a few versions, but the main principle is similar among all of them. In a classic facelift operation, the plastic surgeon performs an incision starting with the hair line, in the area of the temples (which are sometimes shaved prior to the operation), down along the ear's front line, to the point it connects to the ear’s lobe. Then, the incision continues upwards behind the ear cap and onward, into the hair.

After making the initial incision, the plastic surgeon separates the upper skin tissue from the rest of the tissues, so the separated tissue, is about 5 mm thick.
The surgeon must separate the right thickness of skin tissue in order to prevent any damage to the nerve tissues and to keep enough blood vessels in the separated skin. This way it would be easier for the body to heal the skin in the best manner, after it is stitched back on.

After separating the skin, the surgeon stretches the skin layer and the cell layer that is under the skin. The stretch is made upwards from the neck towards the back of the ear and from the cheeks to the area of the temples. In this stage the surgeon estimates how much excess skin is to be removed before reconnecting the tissues to the place the initial incision was made.

After removing the surplus skin, the separated skin tissue is sewn back on, using stitches or gentle pins, where the longitudinal incision was made in the beginning of the operation. Before sewing, drains are inserted to the area to allow proper draining of the blood in the next days following the operation.

A facelift procedure usually includes other operational actions such as removing excess skin from a loose neck with wrinkles, by making an incision around the chin, removing the excessive skin tissues and then reconnecting them back on. In fact, this is a shortening action of the skin tissues that create a young and smooth neck look.

In other cases a liposuction is made as well, mainly in areas where excessive fat could exist, like the chin for example. The fat excess that is taken out of undesired areas, can afterwards fit to fill up wrinkles. This technique is called self-fat transfer and it is especially used for filling wrinkles or making expression lines disappear.

There are doctors who recommend adding implants to sunken areas or insert filling materials, either temporary or permanent to fill in wrinkles. These treatments are designated to give the optimal look and make the wrinkles disappear as well as to maintain the results for the long run.