Are Sutures Ever Placed Horizontally in Back of Head at the Hairline?

The reason for doing one or the other depends on what the surgeon is trying to accomplish. Many surgeons place the incision at the hairline for a better direction of pull if that is what is needed.

There are several different types of facelift incisions.  All facelifts involve an incision in front of or partially inside the ear and then extending to the back of the ear.  In many of the incision designs, the incision extends either along the hairline behind the ear or back into the hair itself.  Every surgeon designs their incision differently.  I customize the incision based on the patient's anatomy and to achieve what I think will be the best result for the patient.  If you like the results that you see from your surgeon they go for it.  Good luck with your surgery.

A Facelift (when employed to address neck laxity) involves an incision that follows the crease behind the ear, traverses horizontally across non-hair bearing skin, into/along the occipital hairline.  This allows for removal of redundant skin.  There are numerous modifications of this incision.  I utilize the modification described by Dr. Connell which allows for skin removal and a natural appearance to the hairline.

There are about as many correct ways to close a facelift as there are facelift surgeons.  No method works best in everyone's hands.  This is part of the art of the subject which is often not talked about so much.  It is not a matter of what is best.  This is an individual's particular solution.  However, I will caution you that these types of details are what distinguish a great facelift from one that is not so great.  

When one looks at the proprietary facelifts that are widely advertised compared to a detailed and customized facelift, it is the tailoring that makes the difference.  Tailoring takes time and time with a surgeon often equates to increase cost.  Although it is difficult to understand precisely what you are paying for, surgeons who know how to properly finish a facelift worth seeking out.  You have to live with those facelift scars for a very long time.

The traditional necklift operation is not going to address excess skin. Excess skin needs to be addressed through a face/necklift. The classic necklift operation itself is only going to address tightening the muscles of the neck and removal of fat both above and below the platysma muscle. The only incisions for a necklift that are performed are behind the ears just for access points for the liposuction along the jawline.