Facelifts are definitely not all the same. Over the years the techniques have evolved for facelifts and there are many forms that are currently being marketed. What is confusing is do you need one and which one is best for you. There are some basic principles that we have learned in rejuvenating the face including how we analyze the anatomy. In the beginning we tended to focus on the skin and did procedures that only addressed this problem of sagging skin and wrinkles. However, our results tended to look unnatural and to not last very long. The pendulum swung the other direction and more invasive deeper procedures were developed. The results were better but the cost and recovery was more intense. Now, more and more physicians are trying to get into the game-the cosmetic business. They tend to market their procedures as minimally invasive and little down time. That may be the case and may work well in some-usually the person that needs the least. Otherwise, the results tend to look unnatural and not last very long. From my standpoint the facelift should be only part of the picture in rejuvenating the face. One needs to address the whole area-brow, eyes, midface, and neck-and make a individual plan for each person. We cannot assume that the face changes the same in all areas at the same rate. So, fit the procedure to the needed changes and not to a gimmick or how inexpensive it is.