Ever wonder why some people look so "pulled" or fake after a facelift, while others just look naturally rested and younger? What is the secret of so many celebrities, who have undoubtedly had a little lift, but still manage to look natural? The difference can be found in several areas of the face and technique.First of all, surgeons must lift the right tissue layer.  The muscle in the face is the most critical area to lift, not the skin. The oldest facelift technique was to actually pull the skin back tight, This did not achieve optimal aesthetic results, and in addition the effects did not last. The next wave of facelift technique was in the 1980's and involved lifting the fascia rather than the skin. This was an improvement, but still created unnatural results.  Then, more recently in a study performed by Dr. Anil Shah of Chicago and Dr. David Rosenberg, they found that this muscle, once thought to be solely a neck muscle, is actually a face muscle- making up significant portions of both the neck and face. This technique eliminated the pulled component, because it lifts the facial anatomy, created a youthful, natural face with the added roundness of youth.Other important areas that separate good facelifts from bad facelifts, one of which is scarring. While each patient has individual limitations on scarring and potential for scarring, dedication and commitment to minimizing scar is critical from the surgeon perspective.  The ears are also important signs of a natural facelift. Some patients can have "pixie ears" or attached ear lobes after a lift, creating an obvious stigmata of having had a lift.  Overall, a facelift is not meant to make a person look pulled or stretched but look subtly younger without signs of having had work done.