I am ignorant to the curl lift but after reading about it, I believe that there is no excision done of excess skin. Under local anesthesia there is a pulling up of sagging skin and suturing this in place. I believe there may be an issue of excess skin pleating or bunching up in one area. The question of longevity needs to be addressed. This is not a no down time procedure. It is minimally invasive but should not be very painful at all as local anesthetic is injected. Ultherapy is a no down time, non invasive procedure. it is painful as typically there is no local anesthetic injected, although there are exceptions The amount of lift from a non surgical procedure is rarely the same amount of lifting that can be obtained from surgical manipulation including suturing. Thread lifts, where barbed sutures were placed to pull up the skin were often found not to last long and those sutures were left permanently in the face. This of course does not take place with Ultherapy and the results can last more than a year or two.