The
MACS lift (Minimal Access Cranial Suspension Lift) was
described as a modification of the S-lift by a Belgian
group in 2001. It was reported in the Plastic &
Reconstructive Surgery journal, which is the main scientific
journal for plastic surgeons.
How does it differ from
a traditional face lift?
1. The incision is limited
to the skin hairline junction above the ear and anterior
to the ear. There is no extension behind the ear.
2. The area of undermining, unlike a conventional
facelift, is much smaller and only involves a portion
of the cheek. Because there is less undermining, the
blood supply to the skin is much more robust and the
technique is therefore safer in smokers. There is much
less risk of any skin necrosis, unlike other lifts.
3. Permanent suspension sutures are used to elevate
the underlying tissue. These pass down to the neck,
jowls and cheek fat pad. Unlike many other facelifts
which do not include significant mid face elevation
the MACS lift elevates the malar fat pad reducing the
naso labial folds.
4. Because there is no undermining under the
SMAS (superficial musculoaponeurotic system) there is
very little likelihood of damage to the facial nerve.
5. Because the undermining and dissection is
much more limited the post operative swelling and oedema
is much less than in normal facelifts and recovery is
therefore uicker.
6. Because the malar fat pad is elevated it combines
very well with lower lid blepharoplasty, as can be seen
in the illustrations. The result is a reduction in the
height of the lower eyelid giving a more youthful, smooth
appearance.
7. In nearly all cases liposuction is performed
to the neck area below the angle of the mandible, both
to remove excess fat here and also to free up the skin
to allow it to be re-draped by the suspension sutures.
8. The MACS lift produces results at least equivalent,
or in most cases, better than a conventional facelift.
It is ideally suited to the younger patient with a sagging
mid face. In patients with marked sagging of the neck
it may be necessary in some cases to make an incision
posterior to the ear to take up this slack, but in most
cases this is not necessary.
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How is the operation done?
The operation is performed under
a general anaesthetic and most patients stay in hospital
for two days following surgery. The operation generally
takes about three hours and in nearly all cases should
be combined with lower lid blepharoplasty, as lifting
up the malar fat pad also lifts up the lower eyelids
and it is relatively simple to remove the excess skin.
Usually no additional work needs to be done to the fat
pads because of the suspension of the malar area.
How long is the recovery period?
During the first post operative
night, the patient is placed in a firm bulky woollen
bandage and two small non-suction drains are inserted
behind the ear. The bandage is removed the following
day, along with the drains.
Following this, a light chin-up bandage is worn for
one week. Following this, there may be some residual
bruising, particularly around the eyes. This is treated
with Arnica cream and massage on a twice daily basis.
When will the stitches be taken out? Stitches in the
lower blepharoplasty incision are removed at three days,
those in front of the ears and alternate stitches in
the hairline are removed at five days and the remaining
sutures in the hairline at ten days.
Why should I have this procedure
over a traditional facelift?
The MACS lift is a significant
advancement in facial rejuvenation surgery as it involves
relatively little undermining and consequently the recovery
is quicker. It also has the significant advantage of
improving the mid face and malar area which other facelift
techniques do not tend to affect
How long will it last?
The positive effects of a MACS
facelift last for about 10 years, but are dependent
upon the elasticity of your skin as well as other considerations
such as diet and exposure to UV sunlight rays.
To view MACS Lift before
and after photographs please click
here
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