Lasting Results for MACS & PSP, is SMAS Included to Secure Muscle? (photo)

16 years since I had facelift and so far 5 doctor's responded to my question as to alternative to fillers and botex all seem to agree that a lower facelift is in order. Susie49 asked about longevity of MACS & PSP; not sure what these terms mean but I clearly don't want want anything like the "lifestyle lift" where they just pull the skin and don't secure underlying muscle. Will a MACS/PSP resolve the puffiness and nasialfolds as well as loose neck or will lipo resolve neck looseness?

Doctor Answers 9

Loose neck skin

After looking at your photos you have bands of platysmal muscle that need correction and also loose skin so at the very least a necklift but I would recommend the face/cheek areas as well.

Fort Myers Plastic Surgeon
4.9 out of 5 stars 62 reviews

MACS Facelift gives Long Lasting Results

I have basically used a MACS technique with some modifications (Lite Lift)  for the majority of Facelifts performed over a 12 year period.I perform about 100 facelifts per year. The MACS procedure involves significant SMAS elevation of the neck and cheek tissues. Because the lift is purely vertical, it gives you a natural appearance without the need for major incisions behind the near and into the scalp (about 40% less scarring than a traditional facelift). At first, I told my patients that it would accomplish about half of what a traditional facelift would. I no longer say that and it appears just as good as the traditional facelift with the exception of the lower neck. The results are long lasting and in fact I have done a secondary Lite Lift/MACS in only a few patients after 10 years. 


Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Lasting Results for MACS & PSP, is SMAS Included to Secure Muscle?

 I have performed  Face Lifts for over 25 years and Aesthetically, your face shows signs of aging with laxity in the mid face and neck as well as flat cheeks.  The MACS (SMAS suspension type lift) or any type of Face Lift, large or small, must IMHO include dissection/trimming and re-suturing of the SMAS (called Imbrication) as part of the lift and can't simply use some  (any) form of SMAS plication or fixation.  The non-imbrication types of SMAS manipulations that include plication and suspension (asin the MACS lift) are quick and easier on the surgeon but do little or nothing to rejuvenate the face in the long run IMHO.  

  I use a minimal incision Face Lift that includes SMAS Imbrication as well as Cheek Augmentation and removal of excess neck skin called the "Celebrity Face Lift".  IMO, it's essential that the plastic and cosmetic surgeon understand and follow the proper aesthetics of facial beauty for the creation of a naturally more attrcative face.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Mini facelift

Mini face lift deals with the mid face and jowles, mild effect on the neck.

The pictures posted , need a SMAS Facelift for optimal results.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews


I'm not sure I know what a PSP is but the term MACS lift refers to a type of minilift that definitely includes lifting and tightening of the SMAS, not just skin. You appear to be an excellent candidate for this type of lift and should do well with it.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews



A mini-facelift with tightening of the SMAS should fix the jowls and the submental skin you have under your chin. The naso-labial folds are NOT corrected with a facelift and can be injected with fillers.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 272 reviews

Platysmaplasty and Facelift

   There are many options here, but a facelift with SMAS plication with platysmaplasty will produce excellent results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Suture Elevation vs Facelift

Suture elevation is an easier way to lift sagging facial skin, but the extent of the improvement and the duration of the results do not justify a lesser procedure for most patients. A neck lift will address the bands under your chin but you also have relaxation of the jowls and sides of your face in front of your ears. After reviewing the pictures submitted and examination over the internet I recommend a full face lift so you can achieve another 16 year result.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Limitations of MACS Lift

My personal opinion is that the MACS lift provides a result of limited duration when compared to a properly performed SMAS imbrication technique.  Although a MACS lift is presented as a minimal incision procedure, the extent of skin undermining necessary to gain the desired result is fairly aggressive.  Although the incision is shorter, the sacrifice made is that all of the facial skin removed is done so in a vertical plane, and removal of lax neck skin is limited.  Neither a SMAS imbrication technique nor a MACS lift will significantly help nasolabial folds.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 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.