After MACS face lift can anything be done to remove matriarchal lines and improve a not so firm jaw line?

Macs face lift 14 months ago. From three months I felt the jaw line wasn't as firm as I had hoped and now matriarch lines appear as bad as before lift. I feel as if one side if my jaw looks puffy and the other sagging. I am 60 years old, perhaps the macs lift was the wrong procedure for my age!

Doctor Answers 8

Suboptimal results after MACS lift. You don't necessarily need a "different" lift technique, just a better-performed second one!

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You are now over one year from your MACS lift, and your results will not "get better" with any additional passage of time.

A properly-performed MACS lift in an appropriate candidate can be a wonderful limited-incision option, but it often cannot address the anterior jowl or submental areas alone without additional steps. Without photos or personal examination it would be wrong to criticize your surgeon's choice of procedure or his/her technical execution of the actual operation, but it seems clear from your description that you require "more" than was provided. This means more surgery, perhaps a different type of procedure (more extensive lifting) and slightly different incisions.

The good news is that a well-performed SMAS facelift with incisions that extend behind the ear and into the pre-auricular and post-auricular scalp are just as hidden and invisible when healed as the MACS lift incisions. Of course, that implies proper incision placement and good healing. but the only visible incision with both limited-incision facelifts AND full SMAS facelifts is the one in front of the ear, so choose your surgeon and his/her preferred technique and incision placement with care.

You should see one or more ABPS-certified plastic surgeons with significant facelift experience (that implies a fair degree of seniority and good before and after photographs, all of which should be evidenced by member ship in the ASAPS (aesthetic society) as well as ASPS membership.) Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

MACS Concerns - See your plastic surgeon

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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.

Unhappy with MACS lift result

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Thank you for your question about your face lift.

I am sorry things didn't turn out as your hoped.
  • My experience is that the MACS lift does not give the improvement that a standard face lift does.
  • And it more easily causes distortion.
  • I suggest you discuss your concerns with your plastic surgeon  or get a second opinion.
  • You may need a revision or re-do of the surgery.

Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Minimal incision facelifts you'll compromise results.

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The desire to minimize the length of the incision is Admirable but limits the capabilities of the facelift. Facelift incisions are almost invisible and the results of a properly executed facelift are predictable and long-lasting.


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It can be frustrating to have something not turn out exactly as you hoped.  A MACS lift is limited in treating the neck, but without pictures it is hard to tell.  I can tell you if you were my patient I would want you to come to me and tell me how you feel so we could review your pictures and talk about options to get the very best result.  I would encourage you to talk to your surgeon, at one year revisions can typically be done if indicated and you could have the look you wanted.

Melanie L. Petro, MD
Birmingham Facial Plastic Surgeon
4.7 out of 5 stars 31 reviews

Limited procedures often bring limited results

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MACS lifts are minimally invasive but often fall short when tightening the neck and treating marionette lines are a priority. I suggest first trying Ultherapy to see if  this nonsurgical alternative would sufficiently tighten your skin. If not I recommend a Secondary Facelift using a different technique. Good Luck.

Seth A. Yellin, MD
Marietta Facial Plastic Surgeon

Revision facelift after MACs lift

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Without seeing photos or you in person, it is difficult to say what would be best for you, but if you feel that you have sagging around the jaw, then perhaps this can be revised using a different technique.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Limited facelift result

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In my opinion limited surgical facelifts gives somewhat limited results. For someone over 55 ,and who may have looked older than her age , a more extensive facelift could give better long-term results. However many of these limited type lifts , such as the MACS lift  ,can give long-term improvement. Further work might be needed to give you the results you're looking for. Sometimes injectable fillers can work for what you describe.

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon

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.