Superior results with the Minimal Access Cranial Suspension (MACS) Facelift

By: Marco Rizzo, M.D.

Recently, I have started doing a new type of facelift procedure, called the “MACS” lift. This is an acronym for “Minimal Access Cranial Suspension”. This is a new concept; mostly is related to the SMAS, another acronym that stands for Superficial Musculo-Aponeurotic System. In the MACS lift, this system is sutured in a purse-string manner and pulled and tied in the upward direction to a strong structure call the temporal fascia using strong sutures such as 2-0 Proline or Mercerline or PDS. Lately the author has promoted the use of PDS sutures, which will be absorbed within three to four months.

The use of three loops, usually two vertical and one oblique is to address the sagging problems such as the jowls, neck and malar eminence. The neck will be treated in two ways: first, by liposuction to remove the excessive fat, and for the sagging skin the suspension of the SMAS.

For this type of surgery, it is important to choose the right patient for this procedure. This method is excellent for patient with skin that is a bit thick and with some fat on the neck – chubby patients will do better. It is not indicated for patients who have most of their problems on the neck, especially Caucasians with thin subcutaneous tissue and sun damage and hanging skin. For these patients, we recommend the standard facelift with plication of the SMAS or with smasectomy as well.

The MACS procedure takes about 1.5 hours less time than the standard procedure and can easily be combined with lower lids blepharoplasty or other procedures which might be indicated.

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Dr. Marco Rizzo is internationally recognized for his expertise. He has taught hundreds of American and international Plastic Surgeons over the years, including teaching courses for professional societies including the American Society of Plastic Surgery, the Pan Pacific Surgical Association, and the Hawaii Plastic Surgery Society. Visit his website and learn more about plastic surgery and medical skincare products at: www.plastic-surgeon.org.

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