7 Weeks Post Op and Very Disappointed With MACS Facelift?

I had a macs facelift, upper and lower eye lift and fat transfer to cheeks. Wrinkles reappearing under my eyes and cheeks look like they are sagging already. Until last week I was very happy with the results but during the past few days the swelling has subsided radically and I look old again. Is it possible that the fat in my cheeks has begun to be absorbed? Is it that at this stage we look worse before we look better or has this lift just failed and I will have to undergo more surgery.

Doctor Answers 12

Middle access facelifts yield good results only on selected patients.

Whereas limiting the length of the incisions is always admirable when applied to improper clinical situations the results can be disappointing. The operation has to be tailored to the anatomic need to the patient. The description sounds as though more formal facelift with have yielded better results. Fat injections are unpredictable at best.

Atlanta Plastic Surgeon
5.0 out of 5 stars 25 reviews

MACS Facelift AND Fat Grafting

The MACS Facelift produces fullness in the cheek area and typically some bunching beneath the lower eyelid. This typically can requiring a lower eyelid lift at the same time to reduce the bunching so adding fat to the cheek/eyelid area seems a bit unusual but I do not have your before photos.  It has been less than 2 months and the swelling  will continue to resolve.  Give it more time your result may be just fine.

Dr. ES

Fat graft "take" vs face lift laxity


Thank you for the question.  All lifting procedures that are based on soft-tissue such as face lifts will have some degree of return of laxity.  The weaker the tissue, the farther the pull, and the more its tightened the higher percentage of laxity to return.  This is a normal and expected part of facial rejuvenation.  If the amount of laxity is too much for you a re-tightening procedure will be needed.  Luckily the recovery from this is usually not as long and the procedure not as involved.  With respect to your lower eyelids additional fat grafting may be needed but you may also need lower eyelid tightening and/or skin resurfacing.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 144 reviews

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Unhappy with face lift result

Thank you for your question about healing after your MACS face lift.

MACS = minimal access cosmetic surgery - ie, short scar. My thoughts:

  • 80-90% of fat transfers tend to absorb. 
  • Your reappearing wrinkles might be from sun damage of the skin that need skin care and skin peels to improve, rather than surgery.
  • I do standard and MACS face lifts. The MACS face lift looks great at first but is more likely to need touch-up procedures. See your plastic surgeon and review your before/after photos to see what can be done. Best wishes!

Results will not improve with time.

I'm sorry you are disappointed with the results of your surgery.  It sounds like you were happy during the time of the most swelling ( which plumped out your face and made you look younger ) but now note minimal long lasting effects.  In spite of  the marketing buzz, the best science I know of shows only 30 - 40% of the fat placed in any location truly is retained; the rest is absorbed and that volume is lost.  The threads used to lift the deeper tissues of the face may "cheese wire" through the tissues resulting in loss of the lift.  Follow up with your surgeon.  You may be a candidate for a regular facelift which, if done properly, provides good results.

See Your Surgeon for Concerns

Without photos and an exam as well as reviewing your surgical note details it is not possible to give accurate opinions or advice. I suggest that you return to your plastic surgeon with your concerns.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 110 reviews

Face lift biplanar smas

after 6 months,ask for a standard biplanar face lift;

your surgeon-if well oriented-should accept with a low revision price

Vladimir Mitz, MD
France Plastic Surgeon

7 Weeks after MACS facelift and fat grafting

    Some of this can be the reduction in swelling and not fat graft loss.  It is helpful at this point to compare before and after photos to determine the change.  Kenneth Hughes, MD Los Angeles, CA

Analyzing results after facial rejuvenation

is not usually done until you have healed adequately.  Yes, you can get an idea of what is going to happen at this stage but the final results can still change.  You should discuss your concerns with your surgeon and you will have your pre-op photos to compare your post-op results with and usually you can easily appreciate the improvements there as opposed to viewing yourself in the mirror.  This is where revision policies of your doctor are important so you know exactly what kinds of costs your are looking at should you and your surgeon determine a revision could be beneficial.

The MACS facelift certainly has its benefits but your surgeons judgment and skills have a bigger impact on the outcome.

Curtis Wong, MD
Redding Plastic Surgeon
5.0 out of 5 stars 30 reviews

7 weeks post-op

It can take up to 6 months for you to be able to fully assess the outcome of your face lift surgery and fat grafting

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 194 reviews

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.