MACS Facelift without including under eyes?
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.
Peter A Aldea, MD, FACS
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.
Facelift and Blepharoplasty
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.
A MACS Facelift can be extended to improve the under eye area
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.
MACS facelift and eye lid surgery
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.
MACS facelift and optimal result
A MACS lift is a type of short-scar facelift. In the classic MACS lift, there is no under eye incision. There are however many modifications to the MACS lift.
One of the situations that can be encountered when performing a MACS lift is bunching. This can occur in the cheek or temple. The MACS lift can really lift the lower face and cheek, which can also cause an excess of skin in the under eye area. A lower lid incision may then be necessary to create a smooth contour to the lower eyelid.
Another modification is a small incision back by the hairline. This is done to remove excess skin from the neck that is not addressed my the standard MACS lift incision.
The idea of the MACS lift is to create a youthful facial appearance with as little downtime as possible. The operation is then tailored to meet the patient's individual needs.
MACS Lift has no effect on eyes, Extended-MACS does
Congratulations on your decision to undergoe a MACS lift - based on the photo here - you appear to have the type of facial anatomy that can benefit from this effective facelift approach.
Let's be very clear about your lower eyes though - the MACS lift as performed and designed by Drs. Tonnard and Verpaele does NOT affect the lower eyes. The Extended-MACS lift does (in this version the skin flap is extended to the area close to the lower eye muscles and the lower eye can indeed look pulled).
Please be sure to sit down with your Surgeon again and ask what form of MACS lift he/she is doing and what you can expect based on your anatomy. Also ask why he/she is not doing anything for your lower eyes. Does he/she feel it is not necessary? Is there an anatomical risk of a poor result if they do a blepharoplasty surgery (lower lid surgery)? Do they feel you might be better off with a chemical peel or laser? Are they indeed doing an Extended-MACS lift where your midface and lower eyes will get some benefit?
One more point I would recommend (again based on this one photo) is to ask if they plan on doing anything for the area under your chin (open or closed liposuction). While the MACS can be very effective for the jowls / jawline, patients with fat under the chin end up not happy with how it looks after the procedure if nothing was done to address the area.
Ciao and Best of Luck,
Dr. Kamran Jafri
MACS Facelift without including under eyes depends
While I most often perform at least a lower eyelid pinch blepharoplasty with a MACS lift, it depends on whether you need it. If you do have extra lower eyelid skin and puffiness, then a lower eyelid lift at the same time as the MACS lift is appropriate. If you don't have extra lower eyelid skin, then the MACS lift alone will not cause an excess of lower eyelid skin and therefore you would not need the lower eyelid lift.
I literally just performed one with a lower eyelid lift but only because she needed it.
Best of luck!
See a plastic or facial plastic surgeon who is a facelift specialist.
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.