As an Ulthera provider and as a surgeon who also performs facelifts, what you have to understand is that each has their place for facial rejuvenation. For those women who have early signs of skin laxity and loss of elasticity and support in the face, Ulthera is perfect. Results do vary, but in my hands, everyone has had photographic evidence of tightening of skin and some lifting of the cheeks and neck. The previous reply was very biased. SkinTyte is a valid therapy using the same philosophy as Ulthera. The statement that there is no control with Ulthera is wrong: Ulthera provides an ultrasound picture of the layers of the skin and face during treatment showing precise delivery of energy.
If you want surgical results, you will need surgery. There is no way around that fact, and if you wait too long and laxity is too far gone, both treatments will yield less than optimal results. Both Ulthera and facelift depend on the quality of tissue offered to the surgeon. The only way to know if Ulthera is appropriate, is to see a physician that can offer both and provide an honest opinion. If you go to a provider who cannot operate, then you will get an answer that is "always Ulthera." If you go to a physician who does not have Ulthera and only does facelifts, you will get an answer that is "always facelift." The only way to know which is right for you is to have your face evaluated by someone who can offer both, and offer an honest opinion as to what can be achieved in your unique situation. Every patient is different, and thus requires consultation.
I hope this helps!