Biltmore Plastic Surgery is a facial plastic surgery practice in Cashiers, North Carolina, led by David Harley. The practice focuses on individualized facial rejuvenation, with particular emphasis on facelift and neck lift procedures designed to restore balance, definition, and youthful contours while maintaining a natural appearance. Its approach centers on personalized attention, structural refinement, and treatment planning shaped by how aging affects each face differently. Procedures are performed under local anesthesia, with an emphasis on advanced techniques, minimized downtime and risk, and results intended to look refreshed rather than overdone.