MACS Facelift Without Including Under Eyes?

You may certainly undergo concurrent facelift surgery and lower eyelid surgery. The MACS lift will definitely manage your lower face and jowls, but, if you are concerned with your eyes, it will not address this area at all. You may also want to ask your surgeon about the decent of your mid face when you have both decided on a plan for your lower lids.

Yes, it is possible to #combine an eye lift with a #facelift. In fact, I commonly recommend other procedures to go accompany a facelift, such as #blepharoplasty or a midface (cheek) lift, to name a few. The combination of multiple of facial procedures may create an optimal result.

The best procedure approach will be discussed in greater detail during your one-on-one #consultation. I invite you to visit PacificCenterPlasticSurgery.com to view a complete list of surgeries commonly performed. The first step is to seek a board certified plastic surgeon who is highly trained with your desired procedures. I also encourage you to look at before and after photos of the surgeons actual patients. Also, reading patient reviews of those who have had combined surgeries will be beneficial. Gathering all of this information will help you make a well-informed decision.

A blepharoplasty (eyelid procedure) and be done at the same time as a MACS lift. It is an independent procedure and should be discussed as such. 

A MACS lift is a form of mini-lift that utilizes two suture loops in order to purse string the SMAS, followed by redundant skin removal.  Although the photo is limited to a frontal view, a SMAS lift or other form of mini-lift should be helpful in addressing your jowls and jawline.  Can your lower eyelids be addressed at the same time?  The simple answer is that they can technically, but your Surgeon may seem something in your examination which has affected his/her decision making.  My personal preference with addressing the SMAS (the deeper fibro-fatty layer) is to elevate and reposition it, a technique known as imbrication.  A MACS lift alone will not be very helpful for your neck and addition of volume to the cheeks would also be helpful.

 You are right! Both can be done at the same time and you will get a better result. You need to see an experienced facelift surgeon to discuss these issues but also a mid face lift as well with the pros and cons of each.

Dear cactus5555:
Thanks for sharing your photos. This is helpful.  Without a full in-person exam, I can only generalize. I see a woman with moderate thickness to your skin, 3 of the “5 Facial Folds”, mild rounding of the lower eyelids, full but slightly thinning lips, mild jowling and mild central neck fullness with no neck banding.

The “5 Facial Folds” are due to laxity of the facial soft tissues and skin creating a wave-like folding along the:

eyes,
naso-jugal (tear trough),
corner of lip (not in this photo),
marionette / jowl, and
neck (not in this photo)
In my experience, the MACS facelift is best for those patients requiring a small or “booster-lift”, ie. younger patient with minimal skin excess or following a prior facelift with minimal skin redundancy. I do not believe you will best benefit from the “minimized” facelift and it certainly will not address the jowls and neck. It is limited in skin removal as well as limited in its undermining to properly redrape the skin around the nasolabial fold / corner of mouth / marionette fold and jowl.

Based on the one photo, I believe you would best be served with:

A more traditional subcutaneous face and neck lift.
High SMASplasty; a lift of the SMAS to the cheek line which lifts the soft-tissues under the skin including the jowl and platysma.
No platysmaplasty needed but the neck would be lifted to maximize redraping of the neck, jowls and jawline.
Neck suspension sutures to elevate your platysma hammock, create a crisper jawline and neck crease.
Fat grafting to the lips and cheeksConsideration for your lower eyelids if the risk of ectropion can be avoided.
ZO Skin Health skin rejuvenation with retinoids and hydroquinone.
I hope this is helpful! All the best!

The MACS facelift can be extended to include the the tissues below the outer portion of the eye. This technique involves a vertical vector of lift and can result in some skin excess or bunching below the outer portion of the lower eyelid and temple which sometimes requires a small pinch excision of skin of the under eye region.

In some patients there is enough improvement with the cheek elevation, that lower eyelid surgery is not necessary at the same time. I recommend that you discuss the MACS technique in more detail with your surgeon, specifically, to give you insight about your lower eyelid concerns.

As a plastic surgeon who does many MACS-Lifts, I suggest that you consider an Extended MACS-Lift to correct your drooping cheek fat. A MACS-Lift alone will not improve that area. If you undergo an Extended MACS-Lift, there will probably be some excess lower eyelid skin which will result from uplifting of the cheek tissue and which should be trimmed at the time of surgery. If you decide to only undergo a regular MACS-Lift, you won't need to have the skin trimmed.

There is puckering that can occur with a MACS facelift. A traditional comprehensive face/neck lift with upper and lower blepharoplasty can certainly be done at the same time rather than going with a MACS facelift. These operations can be done separately or together; however, it is best to undergo one anesthetic rather than two, and one recovery period rather than two different recovery periods.

In looking at your photograph I believe you would do very well with a MACS lift.
You are right to question the seeming illogical exclusion of the lower lids.
The MACS lift includes lifting of the face with 3 O-shaped sutures which elevate the sub skin structures where they belong. In so doing, as the tissues are lifted, the skin is moved up with them creating an excess in front of the ear / side burn and the lower lid which must be trimmed away. Choosing to ignore such redundancy of the lower lid may result in a suboptimal result.
You really need to clarify this point, as well as how your surgeon plans to address your neck in this procedure.
Good Luck.
Peter A Aldea, MD, FACS