Surgical Procedures > MACS Lift

MACS Lift
A softer, more youthful appearance, without changing your features.

A tried and trusted procedure

Most middle age patients who present to a Plastic Surgeon for advice about facial aging want to look younger without evidence of their having had a facelift. Some patients, when the magnitude of a traditional facelift is explained, shy away because of the possibilities of complications. In 1999 a Belgium Plastic Surgeon by the name of Patrick Tonnard described a modified S-Lift Facelift which he named the Minimal Access Cranial Suspension lift. The technique achieved the results of traditional face lifting surgery but through a much smaller incision and with a much lower rate of potential complications. It is a procedure that can be done under local anaesthetic as a day case and patients can, if they so desire, return to work within a few days.

There have many attempts in recent years to minimize the surgery of face liftingand as such the S-lift and contour threads have been invented. Both the S-lift and the contour thread have not stood the test of time and indeed most thread oper-ations merely last a matter of weeks or months at the best. The minimal access cranial suspension lift (MACS Lift) has now stood the test of time and is undoubtedly a procedure of choice for patients seeking to enhance facial appearance due to the ravages of ageing.

The advantages of the MACS Lift can be summarized as:

  • Less invasive

  • No overnight stay required

  • No neck dissection: liposuction only

  • Quicker recovery

  • Less bruising and swelling

  • Can be done under local anaesthetic

  • Few and less onerous complications.

Your consultation: talking it through

When you meet with your surgeon, you'll have an opportunity to share your feelings about the results you want to achieve, learn about what will happen during your surgery and help design a procedure that meets your individual needs. It is often helpful to bring a photograph of yourself from the time when you though you looked your best.

  • Your surgeon will take a medical history and ask about any previous facial surgery.

  • You'll learn about normal differences in facial symmetry you've probably never noticed before.

  • Your surgeon will gently lift your facial skin to assess what you might be able to expect after your surgery.

  • You'll discuss the extent and position of scars you can expect.

Your surgeon will also explain some of the modifications that have improved the overall results of MACS lift surgery. These modifications, all of which can be individually tailored to suit your needs, chin fat removal, and remodeling of the neck muscles. In addition, you'll learn about procedures that can be done at the same time as your MACS lift, including correction of eye bags (blepharoplasty), (forehead lift) and the use of fat from other parts of your body to restore lost volume to the central part of your face. You'll also learn about situations where facelifts can be combined with chin augmentation if the jaw contour is somewhat weak, or midface endoscopic lifts for more pronounced definition of the cheekbone area.

Your operation: what to expect

The MACS lift is done with a small incision from the ear lobe up to the top of the ear which then runs forward in a slightly wavy pattern at the hairline in the temple. Through this incision undermining is done for a distance of approximately 3cm. After the undermining three sutures are placed, the first one down into the neck, second one over the cheek and third one high over the cheek bone. These sutures are all suspended on the zygomatic bone which is about three quarters way up the ear.

These sutures reposition tissues i.e skin, fat and muscle in the position that they were in youth. The sutures are placed in SMAS and lift the SMAS as in traditional face lifting. The sutures are absorbable and disappear in approximately three months. Nonetheless after the sutures dissolve the tissues stay in their newposition because of internal rearrangements and 'sticking down' of the tissues in the new position. Dr Tonnard's results have stood the test of time for six years and his follow-ups show that procedure will last at least this time.

After your surgery

Your bandages will be removed the morning after your surgery. After that, your hair will be washed and you'll be allowed to leave the hospital.

Once at home, it's important to take certain precautions:

  • To prevent post-operative bleeding it's important not to engage in vigorous activity for the first five days after your surgery.

  • Aspirin should be avoided. Any discomfort can be controlled by taking a mild analgesic such as Paracetamol.

  • You may gently wash your hair with a mild shampoo, exercising care in the suture area.

  • You will receive a complete list of postoperative care instructions before you leave the hospital. As your convalescence continues, you can expect certain things:

  • Your sutures will usually be removed seven days after surgery. It is advisable not to apply any strong chemicals like bleach or ammonia to the area for four weeks following surgery.

  • Your scars will usually be very faint at first, however you can expect them to thicken and redden for a few months after your surgery before they return to a more natural skin colour and texture.

  • It is normal to experience some bruising, swelling and numbness after a MACS lift. These symptoms are temporary and should mostly disappear after two weeks. Numbness takes longer to settle down, and it will require approximately a month for the cheeks and three to four months for the underside of the chin. To help lessen post-operative bruising, we suggest taking Arnica for one week prior to your surgery and two weeks after.

Complications from MACS Lift are rare

The benefits of a MACS Lift are substantial. In addition to just a small incision there is no incision behind the ear and patients (especially female patients) are able to wear the hair up in a bun without the stigmata of the behind ear face lift incision. Nonetheless any surgery does carry some risks and indeed the risks of traditional face lift are present in the MACS Lift but to a much lesser degree. There are the general risks of surgery which include:

  • Wound infection (treatment with antibiotics may be needed)

  • Pain and discomfort around the incisions and sometimes in other facial areas.

  • Haematoma (an accumulation of blood around the surgical site that may require drainage)

  • Nausea (typically from the anaesthetic; this usually settles down quickly)

  • Heavy bleeding from the incisions

  • Keloid scars (most scars fade and flatten, but some may become 'keloid' and remain raised, itchy, thick and red. A keloid can be annoying but is not a threat to health.

Additional surgery or

  • chemical treatment may be needed to try to improve the scar)

  • Slow healing (most likely to occur in smokers)

  • Separation of wound edges (smokers)

  • Allergies to anaesthetic agents, antiseptic solutions, suture material or dressings.



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