I'm confused, what exactly is a SMAS face lift, and a MACS?

Thank you for your question.Both are well described techniques of facelifting.The SMAS refers the the deeper muscle layer that needs to be lifted in facelift surgery.  Both techniques will address the SMAS but in a different fashion.The advantage of the MACS facelift is that there is a smaller scar behind the ears.  The SMAS lift is a plication and mostly a vertical lift.The SMAS lift is a slighlty longer scar yet it allows the surgeon to also undermine and lift the SMAS, in 2 and sometimes 3 vectors/directions, a more powerful manoeuver compared to most plication.The SMAS facelift is a slightly more tedious procedure but I find it a more powerful and longer-lasting procedure, in my hand.More important than the technique is to find an experienced board-certified plastic surgeon.Hope this helps.



Warmest regards,



Marc DuPere, MD, CM, FRCSC

This is a great question.  These are different surgical techniques that are use to lift the neck and possibly cheek region. Lets first discuss a SMAS lift facelift.  During any type of proper facelift, the deep layer of the face is tightened to lift the face.  This deeper layer is called the SMAS.  During a SMAS faceflift the SMAS is lifted in a vertical direction in the cheek region and horizontally in the neck region.  The SMAS is secured by multiple single stitches.  During a MACS lift, the SMAS is lifted by 1 or 2 continues stitches.  These stiches are tied tightly to bunch the SMAS together to give the face a lift.  A MACS lift is typically more veritcal in nature and does not require many incisions behind the ear.I preferentially perform SMAS facelift as I believe I get a better result with the technique.  I hope this helps.  

Smaller procedures including  MACS (Minimal Access Cranial Suspension) Facelifts which may be beneficial in the appropriate patient may have slightly
shorter recoveries, but also generally have shorter lasting results. The MACS lift involves a shorter incision, more vertical correction, and  less precise correction of the underlying tissue of the cheek which is called the Superficial Musculo-Aponeurotic System  (SMAS) The
exact technique is far less important than having the procedure performed by an
experienced, excellent artistic plastic surgeon who individualizes the procedure based on your anatomy and desired outcome.It is important to realize
that following the advice from a surgeon on this or any other website who
proposes to tell you exactly what to do without
examining you, physically feeling the tissue, assessing your desired outcome,
taking a full medical history, and discussing the pros and cons of each
operative procedure would not be in your best interest. I would suggest you
find a plastic surgeon certified by the American Board of Plastic Surgery and
ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS)
that you trust and are comfortable with. You should discuss your concerns with
that surgeon in person.Facial rejuvenation needs
to be individualized. What would be an ideal approach for one patient is not
necessarily the same for someone else. Based on the examination and discussion
at the consultation, you should have a better understanding of the various
options that can achieve the best cosmetic result for you.Robert Singer, MD FACSLa Jolla, California