Beneath the skin the next deeper layer is a layer of fibrous tissue blending with muscles called the Superficial Muscular-Aponeurotic System. This layer is separated from the deeper tissues and elevated towards the temple and behind the ear to tighten the deeper structures correcting looseness in the lower cheek, jaw line, jowl and neck. Excess skin is removed and the wounds closed.
The full length scar is required where there is major looseness in the neck. If looseness in the neck is less severe the scar can be shortened to a short scar face lift avoiding the scar behind the ear and in the hair behind the ear. With a short scar face lift a similar manipulation of a SMAS layer is performed but because there is no surgery behind the ear there is less tightening in the neck of the deeper structures.