Traditional Face Lift, MACS or Short Scar Lift: What's the Difference
- Asked by Renee B2 in Vancouver, WA.
- 4 years ago
It the right surgeon that is important not the particular type of facelift
There are literally a dozen of ways of performing a facelift. Surgeons are in general moving away from the classic big omega type facelift to smaller variant types of facelift. However, the key is that whatever is chosen has to be right for you. If you have neck cord and loose neck skin, this needs to be addressed at the time of your facelift. If you have a heavy face or a thin face, the work that is done under the skin flap needs to addressed accordingly.
Studies have shown that over the long term it is impossible to tell the difference in facelifts. So the more aggressive deep plane techniques that have a definite rate of motor nerve injury really can't be justified. However, it is very important to have a natural facelift results. Have the windswept look benefits no one.
I would also caution you regarding some of the heavily advertised facelifts. These are essentially a type franchise. The advertising looks so go but the results have been very disappointing. I think there is no substitute for a high experienced, artistic surgeon who is able to individualize surgeon for your particular concerns. This is one surgery were a cookie cutter, one size fits all approach just does not work.
Finally, Realself is dominated by General Plastic Surgeons. Hear them say it, they are all great at facelifts and you should not go to any other specialist. This is their opinion. Recognize that most general plastic surgeons get very little hands one facelifting experience as the surgeon doing the surgery. Assisting another surgeon is not the same thing as being the surgery. In many plastic surgery residencies, general plastic surgeons are lucky to be the primary surgeon on one full facelift.
It is no wonder then that many general plastic surgeons don't seem to be adequately trained to perform a facelift. The reality is that unless your general plastic surgeon went on to do a cosmetic surgery fellowship, which is rare, they are largely self taught facelift surgeons. The results of this are predictable: suboptimal surgical results. Recognize that facial plastics surgeons get more face lift training than general plastic surgeons. Even eye plastic surgeons now get more facelift training than general plastic surgeons.
So how do you find a good surgeon? It is difficult. Recognize, that just because someone is a board certified general plastic surgeon, this is not a guarantee of a good outcome. Do your homework. Talk to others in your community who have had a facelift. No matter how they love their surgeon, open your eyes and look at their results. Are they over or under done? Has their hair line been damaged? How are the scars around the ears and along the hairline. Don't make the mistake of assume that they will do a better job with you. Check that they have hospital privileges. They should be board certified. If they are a general plastic surgeon, they should be board certified in general plastic surgery. If they are facial plastics, they should be board certified in otolaryngology and fellowship trained in an approved facial plastics fellowship.
Check with your state medical board to determine if there have been any actions against the doctor. Also look at your doctors resume to determine if they are any unexplained gaps. Finally study any before and afters posted on the doctors website. This represents the doctors best work. If you don't like what you seen, look for another doctor.
Understanding terminology is useful in determining what will work for you
I am a facelift specialist and have performed as many as 300 in a year and 10 in a week. Recently we introduced the first laser assisted facelift the LaserSmartLift which we now perform as our standard procedure. It is a new approach that combines short recovery times with exceptional results.
The most important thing to discuss is what you want corrected and the ability of the surgeon to effect this with his operation (whichever one is selected). Many problems can not be optimally corrected with short scars and short flaps. A full face lift involves a very long flap and usually side to side neck dissection and in some patients this may be the best option. Most patients will fare well with an intermediate flap and standard minilift incision that extends partly into the back hairline. Excessive neck laxity may require a longer incision. Think correction not operation Jowls, Nasal Labial Folds, Neck Bands, Neck Laxity. Ask your surgeon how the operation he selects will do in the areas you want corrected the most. No one facelift will optimally correct all those factors so if they offer one size to fit all you may want to seek another opinion. Less is not better Better is Better.
Traditional Facelift: usually refers to an incision that starts in the hairline above the ear, extends around the ear and curves back either into- or along the hairline behind the ear. The lifting techique varies from "skin only," to various SMAS and deep plane techniques.
MACS (Minimal Access Cranial Suspension) Lift: as the name implies, MACS uses a short scar incision, purse string sutures in the SMAS to lift and tighten facial structures.
Short Scar refers to the limitation of the incision, usually just below the side-burn, along the front of the ear, aaround the ear lobe and a short distance behind the ear.
More Facelift Techniques than there are Faces to Lift!
While there is clearly science involved in achieving a good facelift result, there is a whole lot of art as well. Every time one of my colleagues manages to get a good result with a slighlty shorter scar, or performs a facelift in a different plane it tends to get press.
The truth is that you need a surgeon who understands your specific needs should tailor an operation for you. Of course, the trick is the find a surgeon who shares your basic philosophy about how invasive you want to be and how natural you should look when the procedure is done.
Different facelift techniques
There are many different variations of facelifting techniques. A short scar facelift is a technique that attempts to remove excess skin through a short scar. If there is excess skin and significant aging process, then a full face/neck lift has to be performed. Otherwise, excess pleats of skin will result with a short scar. A MACS facelift is a more vertically oriented facelift, which does not address neck issues. It does not address excess skin in the neck, muscle bands, cords or subplatysmal and submental fat. A traditional facelift addresses the jowling process, excess skin, muscle banding in the neck, subplatysmal and supraplatysmal fat as well as tying the muscles in the front part of the neck, the back portion of the neck, and tightening the SMAS layer.
Web reference: http://www.seattlefacial.com
It's not the name but what it does that matters
The traditional facelift involves an incision that starts in the hairline above the ear, extends along the front boarder of the ear, around the lobe, behind the ear and into the hairline. There are numerous variations on this but that's the basics. After this the skin and a small amount of fat is lifted across the entire neck and cheeks to the mid-cheek region. After this several things can be done: 1 The next layer of tissue, abbreviated as the SMAS, can be lifted onto itself and stitched. This is called plication. I don't feel that it gives as good a result as...2. Lifting the SMAS off of the deeper tissues, elevating it vertically, removing the excess and suturing it to the bone. I find this give an excellent elevation of the mouth and jowls. The excess skin is removed and the incisions closed. In addition the neck muscles may or may not be tightened in the midline. This surgery is the gold standard and is good for patients with significant extra skin and facial sagging but can be used on anyone.
The MACS (minimal access cranial suspension lift) involves the same or somewhat less skin elevation. Then the SMAS is elevated by two or three stitches that are passed through the layer in long loops then tied to the deep tissues above the ear. It's a great surgery for many but in particular moderate excess skin and deep tissue descent.
Minimal scar only means a shorter scar than the standard lift. This can involve only behind the ear for a neck lift or in front of the ear for a MACS or similar lift.
It's not the surgical technique the matters. What matters is what the most appropriate surgery for the patient is.
Traditional, MACS, vs short scar: here are the basics
The other respondants have done a great job discussing the very important aspects of choosing a surgeon, as well as the confusion that exists due to the differing terminology used to describe a myriad of facelift procedures. To simplify, though, here are the basic answers to your question.
A traditional facelift (as the term is most commonly used) involves quite a bit of tissue dissection, widespread undermining of the tissues, and a lifting or tightening of the deeper tissues. In general, you can assume that the best results are acheived with this approach.
The MACS lift is a simpler approach, with less dissection, less undermining, and a simplified suture technique to lift the tissues of the jowl and neck. The incision runs in front of the ear like a facelift, but not behind the ear. Not all patients are good candidates for this, but in some patients its a good option. (nearly as good as a facelift.)
Short scar is a catch all phrase - can be used for a variety of "minilift" approaches. Similar to the MACS lift - for most patients wont produce as much improvement as a traditional facelift, but has the advantage in the minds of many patients of being "less invasive."
Hope this is helpful.
Facelift surgery is an art form
Like almost no other plastic surgery operation, face lift surgery is an art form. The results of no 2 surgeons will be the same even with the same starting point. This is a critical thing for patients to realize!
The patient should not be terribly concerned with the "name" of the procedure, ie. MACS lift, deep plane, SMAS lift, short scar technique etc. The technical details are mostly beyond the layman's comprehension and to further confuse you there is a huge amount of overlap between these techniques. Further, there is no standardization of exactly what these terms mean to different surgeons.
What DOES matter though is looking at multiple photos of multiple patients whom that surgeon has operated on and seeing in those results what you would wish for yourself. Here you will see the true art of that particular surgeon!
So do your research carefully and remember that no 2 surgeons are the same and that in most instances, you get what you pay for so don't go for the discounted surgeons or the face lift assembly lines like the Lifestyle Lift.
Check the photos on my web site and compare.
Web reference: http://www.randcosmeticsurgery.com
Traditional Facelift vs Macslift
The Traditional facelift uses longer incisiones that can reach up into the hairline and extend behind the ear and the back of the neck. This facelift is more aggressive, more risky and a much longer recovery because the dissection goes under the muscle and also be extended to the mouth and neck.
Macslift which means Minimial Access Cranial Suspension Lift. This procedure tightens and lifts the neck, removes jowels and redefines the jawline and also pins the muscles of the midface back up taking 10 - 15 years off the face with natural long lasting results. This technique offers a shorter incision that runs slightly above the ear along the hairline, around the ear and sometimes extended behind the ear. The underlying muscles are pulled up but not dissected. The downtime is minimal and there is a very low risk of complications
Customize Facelift procedure to your needs
Traditional Face Lift, MACS or Short Scar Lift: What's the Difference?
The mini-lifts may be tough to choose from because of all the brand names such as LifeStyle Lift, S-Lift, Quick Lift, LiteLift, MACS and others. They focus on improvement of the lower face and upper neck (jowls, marionette lines, upper neck loose skin).
The tradition facelift/necklift is best if you have a large amount of redundant skin and fat or turkey waddle deformity especially the lower neck. A skilled and experienced board certified plastic surgeon will steer you in the right direction
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.