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Facelifts come in many variations and names and, while many are very similar in their surgical technique, others are distinctly different by more than just their name. One such category of facelifts has been that of a family of scaled down versions from more traditional full or extended facelifts known as ‘limited facelifts’. These type facelifts promote lesser surgery and faster recoveries which is understandably very appealing to the public at large. When coupled with clever marketing names (e.g., Lifestyle Lift, Quicklift, Smartlift etc)

One of the early types of limited facelifts is the MACS (minimal access cranial suspension) lift. The MACS lift is based on a preauricular incision only that does all of its lifting in the vertical direction. Besides a more limited scar (none behind the ear), it touts a more natural look because it avoids the incision behind the ear which can potentially  create a ‘windswept’ look. While there are many proponents of the MACS lift, there is little in the medical literature that documents its effectveness and limitations. In addition, while the trend in facelift surgery has been in the direction of  a‘less is more’ approach the underlying question has always been…do they offer more than just a quick short-term improvement?

In the June 2014 issue of the Annals of Plastic Surgery, an article was published entitled ‘Advantages and Limitations of the MACS Lift for Facial Rejuvenation’. This paper reported on a five year review of 88 facelifts performed by a single plastic surgeon. (80 MACS, 8 conventional facelifts) Almost all patients were women with an average age of 59 years old. The only complications were hematomas (3) and a temporary buccal branch facial nerve weakness (1), all in the MACS group. The MACS lift was performed faster than traditional facelifts, averaging just over two and half hours versus four hours. All traditional facelifts were satisfied while three MACS lifts were disappointed due to residual loose facial skin or lack of a good neck contour.

While just 88 patients with a heavy emphasis towards one procedure (90%) does not constitute a real scientific study, nor prove that it is a superior facelift technique, it does reiterate what is already known about the MACS lift. It is a safe and effective facial rejuvenation procedure that does have a rapid recovery. Patient selection is critical and extensive neck aging issues should have a different facelift technique. Also, It does not prove whether it offers comparable results to other more aggressive facelift methods nor how long it lasts.

However, no facelift technique per se has to really prove longevity or superiority. What matters is their safety, a low risk of complications and patient satisfaction.

Dr. Barry Eppley

Indianapolis, Indiana

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