The MACS (Minimal Access Cranial Suspension) facelift is one of the most modern surgical cosmetic procedures designed to rejuvenate the facial and neck skin. This procedure provides long lasting results with minimal surgical intervention.
The direction of the skin traction in most facelift techniques is oblique. However, it has been revealed that this way the face is flattened but not really rejuvenated. Consequently, the MACS facelift technique was developed. In MACS facelift the direction of the deep tissues and skin traction is vertical and that is the essential difference which provides outstanding results.
The MACS facelift is used to reconstruct a saggy neck and (or) jowls (the excess of the skin hanging under the lower jaw). Moreover, it is also very beneficial in the correction of sagging cheeks or deep creases around the mouth and lower eyelids.
The best candidate for the MACS is one whose facial skin is saggy but still has some elasticity. Consequently, the vast majority of the MACS facelifts is carried out in patients who are in their 40‘s to 60‘s. On the other hand, for patients in their 70‘s or 80‘s the MACS facelift is also considered to be highly beneficial.
Since smoking increases the risk of complications and worsens the healing of the postoperative wounds, it is considered as an absolute contraindication to the MACS facelift. It is recommended to stop smoking at least two weeks before the operation.
Furthermore, the MACS facelift is contraindicated if the patient is prone to keloid formation, has bleeding abnormalities or collagen vascular diseases.
In addition, the usage of antiagregants (for example, aspirin) and anticoagulants (for example, warfarin) is also a contraindication. It is required to stop taking these drugs for at least two weeks before the operation if this is clinically feasible.
If the patient has intentions to lose weight, it is advisable to do this before the operation. A more pleasing result will be achieved if the surgeon removes the excess of the skin which often occurs after weight loss.
Furthermore, a patient should consider such things as hair dying. It is important to remember that fresh scars are very sensitive to all chemicals for a few weeks. Therefore, it is recommended to have one‘s hair permed and tinted before the operation.
Usually, the MACS is carried out under the general anaesthesia but local anaesthesia with minimal sedation can also be used.
The score of the MACS facelift is the vertical suspension of sagged facial tissues with permanent or slowly resorbable sutures. The incision begins from the ear lobe, curves up within the natural contours in front of the ear, then continues within the hairline and ends in the temporal area (near the eyebrow). The sutures are attached to the deep temporal fascia (a strong and dense fibrous membrane). A small drain is inserted in the lowest part of the incision in order to remove excessive fluids.
Two variations of this procedure exist:
S-MACS (the Simple MACS) facelift, where two sutures are used in order to correct the aging defects of the neck and the lower third of the face.
X-MACS (the extended MACS) facelift, where the third suture is used to suspend the cheek fat pad. This provides an extra effect on the midface and the lower eyelid.
The MACS technique provides a shorter scar and rapid recovery together with a natural looking lift of the deep facial structures and skin.
Despite the surgeon‘s best efforts there is still a probability of complications. The complications include infections, blood clots, haematoma, skin necrosis (death) and nerve damage. Additionally, skin necrosis is 12 times more likely in smokers as compared to non-smokers.
Cool compresses should be applied for the first 2 hours after the operation in order to reduce swelling. It is also recommended to rest with the head elevated.
Oral antibiotics are administered in order to prevent the infection of the wound. Painkillers, sleeping pills and anti-nausea medications can also be prescribed, if the patient feels the respective symptoms. The doctor removes drains on the next day after the operation. The patient is allowed to return home and take light showers and wash hair from this moment. Most patients return to their normal life one week after the operation with the help of some makeup.