Macs Lift (Minimal access cranial suspension)

A facelift procedure is a rejuvenation procedure performed on the cheeks, jowl regions and neck. Surgery usually involves the removal of excess facial , with or without the tightening of underlying tissues, and the re-draping of the on the patient’s face and neck.

Aging of the face is most shown by a change in position of the deep anatomical structures, notably the platysma muscle, cheek fat and the orbicularis oculi muscle. These lead up to three landmarks namely, an appearance of the jowl, increased redundancy of the nasolabial fold (caused by a descent of cheek fat) and the increased distance from the ciliary margin to the inferior-most point of the orbicularis oculi muscle (caused by decreasing tone of the orbicularis oculi muscle). The is a fourth component in the ageing of the face. The ideal age for face-lifting is at age 50 or younger, as measured by patient satisfaction. There are various types of facelift procedures.

The facelift may also be performed in concert with surgery on the brow, eyelids and neck. Other adjuvant procedures include liposuction to the jowl and neck, Coleman fat transfer or other fillers e.g. hyaluronic acid to augment under filled areas, and botulinum toxin to reduce the wrinkle lines between the eyebrows, the forehead and around the eyes. We use the MACS facelift which is an advancement of the previous S lift. A MACS facelift (Minimal Access Cranial Suspension) uses a much shorter incision and produces less scarring. The scar starts at the earlobe and runs in the crease in front of the ear and at the transition of the and hairline in the temple.


There are essentially two types of MACS facelift.

The Simple MACS Facelift involves the placement of two sutures within the SMAS layer of the face. An Extended MACS Facelift uses the same two sutures as the simple MACS facelift but in addition it also employs a third suture which is placed under the lower eyelid below the outer corner of the eye and extends down on to the malar fat pad region. This produces a more youthful contour to the malar or cheekbone region. Excess generated with this third suture will require a small lower eyelid pinch blepharoplasty to correct the small puckering of the caused by the placement of this suture.

Once these sutures have been placed in the SMAS layer of the face, the lift creates a small drape (usually 3cm) of excess . This is excised in an anti-gravitational manner so that the is lifted in a pure vertical vector. There is no ‘pullback’ effect, which would tend to flatten the face. This affects a lift to the face in the reverse manner in which age has lowered the tissues. It avoids the ‘wind tunnel’ look, which is a classic stigma of some traditional facelifts. A MACS facelift is always performed in combination with liposuction to the submental (under the chin) area. The reason for this is that it removes any fat in that area. This region of the neck is then pulled and lifted into the face and would produce abnormal contour if this area were not thinned appropriately.

The submental liposuction also helps to create a suitable plane to allow release and subsequent elevation of the facial . Dr. Rajesh and Dr. Jacob are well versed with the latest facelift procedures in the world.

The MACS lift involves a short incision in front of the ear, extending a few cm into the temporal hairline. The is undermined to a lesser extent. The connective tissue is suspended from the thick tissue in the temple by 2 or 3 stitches on each side.

The recovery time is much shorter – usually only one week. This technique is particularly powerful at addressing the jowl area and redundant folds of in the neck.

The surgery will produce a lasting result, however it cannot halt the ageing process. It has been stated that “You can turn back the clock, but you cannot stop it ticking.” You will remain more youthful than without the surgery.

The risks will be discussed with you in detail before you consent to the operation. The risks can be broken down into general risks associated with any operation, and those specific to face-lifting surgery.

General operative risks include anaesthetic complications, bruising, bleeding, infection, wound breakdown and abnormal scarring.

Specific complications include visible scars, collections of blood under the (haematoma), wound breakdown, poor healing, loss (necrosis), hair loss within and around the scars (alopecia), deformity of the earlobe, temporary numbness of the cheek and ear, damage to the underlying facial nerve which can produce some muscle weakness, asymmetry and disappointment with the final cosmetic result in terms of extent of improvement and final contour of the neck and face.

A drain will be placed under the on each side. These will be removed on the morning after surgery. Your face will be dressed in a tailor-made support garment which you are encouraged to wear as much as possible for the first week. This garment can easily be removed and replaced by the patient.

Stitches placed in the incisions are removed at day five. A degree of swelling and bruising will be noticeable for at least a week.

A MACS facelift is commonly performed with other facial rejuvenation procedures including an upper and lower eyelid blepharoplasty, fillers, Coleman fat transfer to the perioral region as well as a neck lift.

Classic facelifts do not fill the naso-labial folds or marionette lines although they can lift the adjacent tissues. The use of fillers (autologous or artificial) is a useful adjunctive procedure to compliment the aesthetic results of a facelift.