Patients with prominent folds and wrinkles in the face and /or hanging jawls and neck skin are candidates for this operation. The surgery takes 4-5 hours and is done under local anesthesia. The excess skin is removed, and the muscles and tissues of the face and neck are tightened. Fat is removed from under the chin and neck if necessary. Incisions are made in front of the ears in the natural skin crease and extended up into the temporal area and down into the area behind the ear/scalp. This may be done with a brow lift in which the eyebrows are elevated to a more pleasing position. The incision is usually 1 inch behind the temporal hairline. The operation takes an additional hour to complete. It greatly enhances the final result of the facelift. People with drooping eyebrows and upper eyelids are the best candidates for this operation. Fine sutures are placed, and a loose bandage is applied and removed in 1-2 days.