The incision is extended downward in front of the ear, comes under the ear and then upward behind the ear ending in the hair or hairline behind the ear.
The skin and fatty tissues are then lifted off the underlying muscle and fascia (connective tissue) as far forward as is necessary to correct the loose skin problem.
The underlying muscle and fascia can be tightened with sutures if the surgeon feels it is necessary. The skin is pulled back and upward and the excess skin removed.
The wound is then closed with sutures and skin staples. Some surgeons leave a drain in the wounds to remove excess blood. Bandages are then applied.
There are surgical techniques which go into deeper tissues rather than under the skin and fat. The results are similar.
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