What is the MACS Lift?

Developed in Europe in the early 2000’s and popularized in the last 10 years, the MACS lift is the number one most popular technique for a neck lift (also known as a lower face lift) in our office. Why? Because it is safest and more effective!

Why does the lower face sag as we age?

Youthful faces are fuller and more lifted.  Just look at photographs of yourself 10 years ago and you will likely notice how much fuller your cheeks, under-eye area and temples were!  As both women and men age, they lose volume (fat) in their face which creates hollows and sagging downwards of their neck and jawline.  Much of this lost volume can be most easily corrected by injectable fillers at Horton SPA, many of which last for several years.

The deeper soft tissues of the face also shift predictably, in downward vector.  These soft tissues are the muscles of facial expression and facial fat that comprises a connective tissue network called “the SMAS” (the “submusculoaponeurotic system” of the face).  With age, time, sun damage, volume loss and gravity, the SMAS droops downward.  This creates the dreaded consequences of lower neckline jowls, marionette lines and midface sagging that eventually form in us all and contributes to an aged and tired look.

What can be done to correct this normal occurrence with aging?  It’s simple:  put the sagging soft tissues back upward, where they belong!  The SMAS lift targets the lower face and neck, and re-suspends the soft tissue to a fixed point up higher in the temporal region.  This is a relatively new technique (published in 2003) that is based on anatomic changes with aging and totally makes sense!

Why is this procedure called the MACS lift?

MA stands for “minimal access”.  This means a short scar.  See the picture for an example of where the incision lays.  It starts at the bottom of the earlobe, and travels upward in front of the ear to the bottom of the sideburn, where is zig-zags forward for around an inch.  The zig-zag horizontal incision becomes hidden under the side burn, and the incision in front of the ear lies in the natural crease and is usually imperceptible by a couple of months.

CS stands for “cranial suspension”.  This means that the SMAS is lifted and re-suspended upward to a fixed point on the cranium (the head).  After a skin flap is elevated in the area shown in the diagram, two purse string sutures are placed in the surface of the SMAS to permanently lift it upward in two distinct vectors.  One lifts the jowls directly upward and the other lifts the lower face obliquely from the corner of the mouth region upward.

What are advantages of the MACS lift over other face or neck lift procedures?

• The MACS lift addresses the exact anatomy that is responsible for jowling and drooping of the SMAS, unlike older facelift techniques.
• This procedure creates a short scar that does not need to extend into the hairline in front of the ear or swoop around behind the ear into the scalp.
• The MACS lift creates an upward vector, which directly counteracts the facial aging process, unlike earlier techniques that pulled sideways, creating an unnatural “wind tunnel” look.
• Since the dissection during surgery is superficial to the SMAS, there much less risk of injury to the facial nerve, the motor nerve that provides power to the muscles of facial expression.  This is in contrast to deep plane facelifts that dissect under the SMAS and carry a higher risk of facial nerve injury and partial/temporary facial weakness or paralysis.
• The MACS lift procedure shorter than other all-day techniques, usually less than 4 hours.  The total operative time includes going to sleep under general anesthesia, prepping and draping, performing the surgery, applying postoperative dressings and transportation to the recovery room.   An overnight stay is recommended to allow for restful sleep the night after surgery.  Dressings and drains are removed at the hospital bedside the next morning.  You will be discharged home wearing a comfortable chin strap that will support the repair and help to decrease surgical swelling (see photo).