Surgery is often needed to address areas of loose skin in the face and neck. Removal of extra skin and tightening of the muscles and tissues below is often referred to as a facelift (rhytidectomy) or necklift (cervicoplasty or platysmaplasty). A necklift can correct the turkey-gobbler appearance that people often complain about. Redraping of the skin of the neck as well as disruption of vertically-oriented muscle bands can give a more youthful appearance. A necklift takes anywhere from one to two hours and needs to be done in an operating room with some form of anesthesia.
The facelift procedure is similar: Facial skin is lifted up. The deeper tissues are tightened with sutures, and the skin is redraped after any excess is removed. Scars are usually hard to detect after healing since they're hidden near the hairline and along the ears. Facelifts require an operating room and anesthesia of some sort, and operative time can vary from more than one hour to several hours. The effect is usually dramatic, though the best surgeons will get a rejuvenated but natural result. Results will vary but should last a number of years, unlike Botox or fillers.
Other procedures can be combined with facelifts to raise the eyebrows to a more youthful level (they can droop with age), to rejuvenate wrinkly eyelids, to reduce jowls or to fill and plump the lips. Facelifts are still very popular but cost more than many other procedures and are more invasive.