Is There a Serious Risk of Cheek Bumpiness After a MACS Facelift?
- Asked by Lafonzo
- 1 year ago
I am seriously considering having a MACS facelift. I had a full facelift 7 years ago and one cheek remained bruised for a long time, so I know that I have thin skin as well as a thin face. I have researched a lot and am aware that there can be bumpiness in the cheeks caused by the deep sutres, and I am very concderned that with a thin face I might have long lasting bumpiness. Is this a realistic concern and would there be any treatment should this occur.
MACS Lift for Revision Facelift
I do not recommend the MACS lift in thin face patients. As you have pointed out, the pursestring suturing is prone to bunching, causing an unnatural bumpy appearance in the thin face. As a revision facelift, I would encourage you to undergo a SMAS plication with wide undermining. Revision patients typically do not swell and bruise to the same extent as the primary procedure.
I recommend that you consult with 3 board certified plastic surgeons to help you make the most educated decision.
I wish you a safe recovery and amazing result!!
Web reference: http://www.drpaulgill.com
MACS facelift and Thin Skin
MACS facelift involves pursestring sutures, which elevate the deeper tissues. The sutures can create lumps and bumps and are more noticeable in patients with thin skin. Other techniques may be more appropriate. Find the plastic surgeon with ELITE credentials who performs hundreds of facelifts each year. Kenneth Hughes, MD Los Angeles, CA
Web reference: http://www.hughesplasticsurgery.com/Face-and-Neck-Lift.php
MACS Facelift Revision
I am not a tremendous fan of the MACS Facelift in most circumstances, but would definitely recommend against it in the setting of a thin face. In my experience, the "purse string" of the MACS lift lack durability in aesthetic effect. It's a procedure that is designed more for Surgical speed and more moderate aging indications than a typical SMAS procedure.
Web reference: http://www.drprendiville.com/facelift.html
Properly performed limited facelift...
The concept of a MACS facelift is to perform “minimal elevation of the skin” and to work with a “short scar”. Procedures like the MACS facelift are indicated in some patients with minimal descent and who require a lifting without much effect on the neck area. Given that you have a thin face and there is a concern with bumps I think it is probably better for you to consider a limited “proper” facelift where you are not depending on suspension sutures which literally bunch up the tissue under the skin and lift it up. I think you can achieve (with the right hands) a properly performed limited facelift which can provide you with a quick recovery experience that most people are looking for who are considering a MACS facelift.
Web reference: http://www.youtube.com/user/DrPrasad1/videos
Is There a Serious Risk of Cheek Bumpiness After a MACS Facelift?
Whenever the SMAS layer is folded on itself or plicated with suspension sutures or threads, there is the risk of lumpiness in the face. I prefer to use SMAS imbrication techniques that dissesct, lift and trim the SMAS. This does not leave lumps and is part of our Celebrity Face Lift. Hope this helps.
Web reference: http://www.drfpalmer.com/PalmerCelebrityLift.html
Bumpiness after MACS lift
The Technique of MACS lift involves gathering up the SMAS layer with sutures in order to tighten it. This technique by necessity creates some lumpiness in the deep layer that can be seen through the skin. Patient with thick skin well see this less than those with thin skin. The Sutures can be dissolvable if the surgeon prefers so this usually resolves. Other techniques can cause less of this lumpiness so if you have thin skin discuss your concerns with your surgeon.
MACS lift uneveness
The MACS lift has become en vogue the last few years. It is a simpler facelift and requires less anatomic knowledge than a deeper plane lift. The main issue with a MACS lift is that the skin is separated from the SMAS layer and then a suture attempts to purse string the SMAS and lift it with a permanent suture. This has been changed to a longer lasting suture by some surgeons. The issue is that the deeper tissue is not been lifted but rather gathered so it is very common to see uneveness early after this lift and not uncommon to see asymmetries afterwards.
Bumpiness after MACS face lift
MACS face lift sutures are likely to cause bumpiness in thin skin because -
- the tissue gathered by the sutures forms ruffles. To avoid this the surgeon takes small bites of tissue, not large ones.
- You can feel the sutures under your skin. To minimize this, PDS or similar absorbable sutures are usually used. Bumpiness temporarily increases when they start to absorb - 6 weeks after surgery - and subsides in another few weeks.
Discuss with your plastic surgeon simply re-doing the earlier face lift, instead of doing a MACS. The advantage of the MACS is that the incision is short - but you already have the incision from your previous surgery. The second advantage is that surgery is shortened - but redo face lifts take less time than the first one.
Don't fret - it's nice to have two good options!
Nonabsorbable sutures causing bumpiness
The bumpiness you refer to is likely due to non-absorbable or permanent sutures used for the facelift and is easily avoided by using absorbable or dissolveable sutures. The original MACs lift was described using permanent sutures but now the technique is suggested with an absorbable suture, so that should be one less think to worry about... even if it did occur, it is usually caused by the knot on the suture and that can always be cut out after a few months without affecting the results of the procedure.
Cheek "bumpiness" after MACS lift.
Your consideration of a MACS lift to refresh your previous facelift is a very good one.
Every face lift can cause some lumps and bumps under the skin which resolve in time.
You refer to the suspension suture knots which can be felt in front of your ear and next to your eye. With "non-absorbable" suture material it could be a problem but was most often avoided in "covering" the knots with some tissue oversewn with absorbable sutures. I had to remove some knots after a few months through a small incision in the office without any further problems.
I started to use absorbable sutures a few months ago which disolve after a few months and have been very pleased with it.
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.