Traditional Face Lift, MACS or Short Scar Lift: What's the Difference

The differences in facelifts are significant. The idea of a facelift with a ‘short scar’ appeals to the consumer, but the term is quite misleading. It leads one to believe that you can get the same result with a shorter scar, and the reality is that you can’t. It sounds too good to be true, and it is. In fact the logic behind these procedures really defies logic. Short scar??? The ‘short scar’ and MACS facelifts eliminate the incisions behind the ears, which – if carried out correctly – should result in invisible scars. Scars behind the ears, when placed where they belong (in the depth of the crease behind the ears and hidden in the occipital hairline) are either invisible or very difficult to detect. So why all the fuss? Because a lot of surgeons are not meticulous about making and closing the incisions behind the ears, which has given these scars a bad name. But there is no reason it has to be that way.Hey, what are those odd scars in front of your ears? The MACS facelift moves ALL of the skin excision into the area in front of the ear, which forces the surgeon to create a gathered, pleated and essentially impossible-to-conceal closure around the patient’s sideburns. With a traditional facelift closure the scar in this area may be placed behind the temporal hairline, where it is invisible, or at the hairline, where it can be closed invisibly because much or most of the skin excess has been removed behind the ears.The MACS lift does something that is completely counter-intuitive: moving the surgical scars from areas where they are easily concealed to areas where they are almost impossible to conceal. The term ‘short scar facelift’ is really misleading, as you go from longer scars that can be completely concealed to shorter scars that can’t. So effectively, in terms of visible scars, the ‘short scar’ facelifts are in reality LONGER VISIBLE SCAR facelifts. They are also - as they undermine less skin and undertreat or completely fail to treat neck skin laxity - less of a facelift. And not really a necklift at all, which all facelifts should be.Um, your neck still looks old. There’s just no way around it. In patients with neck skin laxity, if you fail to fully mobilize the skin of the neck as well as below and behind the ears, then it is physically impossible to create a smooth, dramatic and truly rejuvenation neck contour. Unless, as a cosmetic plastic surgeon, you are willing to leave a pile of skin folds and pleats in the lateral neck below the ear. I have yet to meet the patient who will be happy with a sort-of youthful anterior neck but an aged and post-surgical looking lateral neck. And I would derive no joy from providing a patient with that kind of surgical result.Spend some time carefully studying ‘short scar’ facelift (‘MACS lift’ ‘S-lift’, ‘weekend facelift’, ‘Lifestyle Lift’, etc.) before and after photos. You will see, over and over, the following features:Easily visible scars in the sideburn area and in front of the earsDistortion of normal sideburn anatomyGathering of skin (pleats and wrinkles) below the earsUndesirable skin contours below the jawline and in the neckLittle to no improvement in neck skin laxityof course you may also see unfavorable scars in traditional facelift ‘before and after’ photos, so you need to carefully research the physician or physicians you decide to consult with for a facelift procedure. If a surgeon has mastered the High-SMAS face and necklift procedure, the scars should be close to invisible and often undetectable. This procedure, combined with structural fat grafting, rejuvenates the face in a very dramatic yet still very natural-appearing way. And with scars that allow a patient to wear their hair any way they please, including pulled back in a ponytail or gathered up above the ears.

A #facelift is a surgical procedure designed to remove the major folds and wrinkles that form on our faces with age. Gravity, sun damage, smoking, living in a dry climate, and a variety of factors contribute to the aging process of our faces. Facelift techniques vary from patient to patient to give each person a procedure tailored to produce the best possible surgical result. A facelift will smooth out major folds and #wrinkles, #tighten the tissues beneath your skin, remove #sagging and excess skin. A facelift can also reduce excess skin around the #neck and #jawline.  There is not just one facelift procedure, but a whole range of facelift procedures. These different techniques have been developed over the years, involving different incisions and lifting the skin to varying degrees. A facelift may also involve the tightening of certain muscles and tissues, or liposuction of areas such as the jowls or chin.It is important to understand that facelifts are meant to remove major folds and wrinkles, not fine wrinkles. A facelift which removes every line and fold would be too aggressive and would result in an unnatural result. Fine lines and wrinkles are better addressed by skin treatments such as chemical peels or microdermabrasion, which we also offer at our office. Incisions vary depending upon whether the patient is male or female, the hairstyles, hairline, age, previous surgery, and other factors. Generally, the #incision starts in the temple, in front or within the hairline. It continues in front of the ear, sometimes partially hidden within the ear. It then goes under the earlobe, behind the ear fold, and ends within the hairline or at the hairline behind the ear. The newer, shorter scar #techniques, which do not include scars in or by the hairline, can be used for most patients. Frequently another small and hidden incision is made under the chin in a natural skin fold. This allows fat removal and tightening of the platysma muscle in the neck if required.During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.

Great question. It's easy to feel
confused and overwhelmed by the variety of facelift options available to you,
so I'll attempt to be as concise as possible.

A traditional facelift is typically
what most people think of when they think of facelift surgery. It usually
involves an incision around the ears and behind the hairline and improves the
lower two-thirds of the face.

A MACS facelift is a simplified
version of the traditional facelift and may be more appropriate for patients
without significant aging or those who are concerned about recovery time.

Finally, "short-scar"
facelift is not a technical term. Rather, it's a general term that refers to
any facelift that uses a reduced incision. While this option has the advantage
of less scarring, it is a bit more limited in what it can achieve.

Thank you for your question. I hope
this helps to clarify your options.

Thank you for your question. There are many variations in facelifting techniques, and what surgeons recommend. Many surgeons only perform one type, because they are most comfortable with that technique. The short scar techniques have become more popular in recent years because of the smaller scar and the quicker recovery. I often use either a MACS lift or short scar approach if I think the patient will get a good result. A traditional facelift usually implies a longer incision but not necissarily a better result. You should discuss this with your surgeon and look at before and after photos to determine which approach is better for you. Be sure to select a plastic surgeon with extensive experience in facial surgery for the best result. Good luck.

Traditional Face Lift, MACS or Short Scar Lift: What's the Difference?

The mini-lifts may be tough to choose from because of all the brand names such as LifeStyle Lift, S-Lift, Quick Lift, LiteLift, MACS and others.  They focus on improvement of the lower face and upper neck (jowls, marionette lines, upper neck loose skin).  

The tradition facelift/necklift is best  if you have a large amount of redundant skin and fat or turkey waddle deformity especially the lower neck.  A skilled and experienced board certified plastic surgeon will steer you in the right direction

There are many "names" given to the the facelift procedure.  Most are done for marketing purposes.  The most important issue for patients to understand is the more extensive the aging of their skin,  the more extensive the surgery must  be to correct those problems.  There is no one procedure which will work on every patient.   It should be decided, in concert with the surgeon, what corrections are being sought and what procedure has the best chance of delivering that result for any individual patient.  This is a summary of what each procedure offers:

Traditional Facelift:  The incision runs from above the ear, around the ear to the hairline.  The skin is widely undermined allowing full access to elevate and tighten the deep tissues of the neck and face and to remove any unwanted fat deposits.  Once the deep tissues are sculpted to the proper shape, the skin is draped over, the excess trimmed off and the skin closed. This procedure allows maximal skin removal.

MCAS Facelift:  The incision runs from above the ear, to the bottom of the ear but does not go behind the ear.  Less undermining of the skin is done and several sutures are woven through the deep tissues of the face as purse string sutures to elevate the tissues.  Once the deep tissues are repositioned the skin is redraped and excess skin trimmed off.  This procedure does not address the fat deposits in the neck or loose muscles along the front of the neck.  The sutures woven in the deep tissue may be visible or break requiring replacement.

Short scar Facelift:  Many procedures are included in this category and marketed as "minimally invasive". These use a short incision, minimal undermining and predictably give a minimal/modest improvement. Excess skin is harder to remove and sculpting the deeper tissues is more difficult.

The most important take home message is:  don't get fixated on a certain procedure or name.  Consult with your surgeon so a procedure can be agreed upon which will deliver the results you want in the safest way.

As other posters have noted, the most important consideration (from a patient perspective) should be the Surgeon doing the procedure, not details of the technique he/she uses.  However, to answer your question, a MACS lift utilizes a smaller incision and a series of purse strung type sutures through the SMAS, without elevating the SMAS.  In the community, I have personally seen great results from this procedure, and very poor results.  It is certainly not agreed upon to be a better technique than a SMAS elevation and imbrication procedure.  Likewise, there is really no data to suggest that a MACS lift offers less downtime.

The one piece of advice I will offer:  heavier necks, more extensive aging changes, and revision Facelift patients require more extensive procedures than the average patient.  In Facelift, less is definitely not more; there is definitely no new "magic" procedure that can be performed in 60 minutes, with now downtime, that offers long lasting results.  Let your surgeon decide how to apply his/her technique to the concerns that you have.

While there is clearly science involved in achieving a good facelift result, there is a whole lot of art as well.  Every time one of my colleagues manages to get a good result with a slighlty shorter scar, or performs a facelift in a different plane it tends to get press.

The truth is that you need a surgeon who understands your specific needs should tailor an operation for you.  Of course, the trick is the find a surgeon who shares your basic philosophy about how invasive you want to be and how natural you should look when the procedure is done.

Dear Renee,
I have been performing the European MACS-Lift as described by Tonnard and Verpaele, and this procedure has been warmly embraced by my patients and me.
The MACS-Lift is a Face Lift that leaves a small scar in front of the ear and in the temple hairline, and may result in a natural-looking appearance that is never "wind-swept". It's a wonderful operation to rejuvenate the midface, jowls, and neck with minimal inconvenience.
The principle behind the MACS-Lift is that the superficial and deep facial layers are repositioned in a purely vertical fashion with no backward pull that can often look "operated" in appearance.
Problems like scarring behind the ears, funny looking ear-lobes, or changes in your hairline-position are avoided with MACS-Lifting, and there is typically only around 2 weeks of downtime.
I've embraced this operation since it's reliable, versatile, and leads to high patient satisfaction while minimizing downtime and eliminating most of the stigmata associated with traditional "Long scar" surgery. Only those patients with severe cases of sun-damaged, wrinkled facial skin are not candidates. Patient selection, and education is very important.
I think that the surgeons from Belgium who originally described this operation with meticulous detail should be commended for their huge contribution in the arena of face lifting. The operation makes alot of sense, and has worked well for my patients and me.
I've attached a link showing a photo of MACS-Lifting. I hope this helps, and best regards.

 I agree with Dr. Janjua, that there is only a complete facelift and various names for short cut facelifts that won't deliver the same result. See an experienced facelift surgeon and let him guide you as to the pros and cons of each.