The Biltmore Lift is most commonly done using the deep plane facelift technique, and therefore enjoys all the advantages in terms of longevity that this advanced technique provides. Over the years, I have performed several thousand face and neck lifts using a variety of techniques, including SMAS plication, lateral SMASectomy, and the deep plane facelift technique. All of these techniques offer good longevity, but the deep plane technique allows for division of facial ligaments to improve mobilization and anchoring of the tissues. Therefore, the procedure offers optimal results, both natural and long-lasting, while being done in our practice under local anesthesia. Clearly, patients agree and often travel across the country and around the world for the procedures we provide.