Facial plastic surgery is an art, at least for those who have dedicated their careers to it. It is expected that you will get differing opinions from different surgeons. What is important is that what you see is aligned with what your surgeon sees. They should take the time to explain to you how your face has aged and gotten to the point that you are considering a surgical procedure. Make sure that your consulting surgeons perform a wide variety of facial rejuvenation procedures, both surgical and nonsurgical. If one surgeon always uses the same facelift approach, then you may be getting a biased opinion. I recommend seeing a board certified facial plastic surgeon who performs these on a regular basis and will take the time to explain what should be done and why the procedures and approach will benefit you. When it comes to facelifts, very often, the terminology can get confusing for patients. It's important to have an open discussion during the consultation as well as the preoperative visit about the treatment options and the approach that your surgeon is going to use. I also recommend that patients research the information to feel comfortable with the treatment plan. In order to make a facelift look natural, there are many details that need to be taken into account when your surgeon is planning his or her approach, such as the condition of your skin, presence and direction of any skin wrinkles, the direction of muscle laxity, the amount of volume loss, and the change in position of your facial volume to name a few. A facelift should be tailored to each patient's unique aging pattern. It's best to discuss these concerns prior to your procedure. Procedures that I frequently combine with a facelift or neck lift include fat transfer, upper/lower blepharoplasty, CO2 fractional laser resurfacing, and brow lift. Depending on what your goals are, you do not have to do all of these procedures to achieve an excellent result. If your main concern is wrinkling of the skin in the midface, a CO2 fractional laser may be enough. If there is volume loss, the fillers or fat transfer should be discussed. In experienced hands, these can all be done safely under local anesthesia without compromising results. Some surgeons will prefer general anesthesia based on their experience. In order to be able to tighten the muscles in a facelift, an incision will have to be placed in front of the ear. The length of the incision can vary based on the type of facelift being done. At your consultation, you should discuss the type of incision that your surgeon plans on using. They should be able to show you pictures of their patients' incisions at different stages of the healing process. As with any procedure, the experience of your surgeon is very important. Every surgeon has their own way of doing a facelift(i.e. deep plane, modified deep plane, SMAS imbrication, SMAS plication, etc), and neck lift (platysmaplasty). These are very effective and time tested approaches. However, what works for one surgeon may not work for another. Also, the procedure that is performed should be tailored to each patient. Your surgeon's experience is probably one of the most important factors in getting the best result from the procedure that is being done. Look at plenty of before and after photos. Discuss your concern as well as the results that you are expecting to achieve with your surgeon. As always, it's important to do your research before having a procedure done. Make sure that your surgeon is board certified in the field that involves the surgery you are planning on having. In your, case it's also important to see someone who performs a wide variety of facelifts regularly...preferably every week. The surgeon you end up choosing will want to achieve the best result possible for you. I recommend that you start by going back and discussing your concerns with the surgeon who performed your procedure.