“Beauty is in the eye of the beholder.” What is considered attractive in some social or ethnic circles is frowned upon in others. For this reason, ethnic, including social, and/or religious considerations determine a patient’s opinion of what is desirable. Only this consideration may alter the choice of one procedure over another. Assuming the outcome is predefined, that is the goals of face lift surgery are clearly delineated, outcomes should be uniform with few exceptions. Genetic factors and complexion may predispose a patient to loss of pigmentation, or an increase in the same. This is generally observed with resurfacing modalities, like laser CO2, phenol, or TCA peels, rather than face lifting itself. Keloid formation would be an unusual, but cosmetically devastating complication, and is more prevalent in the darker skin patient.