High SMAS facelift or MACS lift for droopy upper cheeks and slight jewels from weight loss?

I had an unsuccessful midface lift about 3 month ago which caused assymetric lips and hollow lower cheeks. Cheeks are horizontal not lifted at all (pulled to side rather than diagonally) and doctor admitted he didn't lift droopy skin and tissue.

Doctor Answers 4

Need for facelift after midface lift

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There are many different techniques for both midface lifts and facelifts. In my experience they do different things. Midface lifts generally address the area in the cheek directly below the eye. It helps to provide for more fullness in the cheek, move the fullness closer to the eye (orbit) and to provide a smooth transition from the cheek all the way through the lower eyelid. Facelifts typically do not do such a great job in this area. If midface lifts are not performed, the same issues can many times be addressed with fat grafting. 

Facelifts are better for addressing th sides of the face and jowls. They can restore fullness and youthfulness by moving the support system (SMAS) in various ways. The combination of the two types of lifts is often used in order to provide for a better balanced and more natural result.

SMAS facelift

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A SMAS facelift can help elevate the cheek area. You would have to be evaluated in person to determine what might be necessary to achieve your goals.

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

Face lift with SMAS

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Midface lift is usually a limited discounted procedure. A full jowl lift is best performed with a SMAS for optimal results. After rthe SMAS, the excess skin is trimmed under no tension. The MACS is similar to an imbricated SMAS with greater likely hood of contour irregularities under the skin. Best to see a board certifiesd ASAPS plastic surgeon. Good luck...

Larry Weinstein, MD
Morristown Plastic Surgeon
4.9 out of 5 stars 11 reviews

High SMAS facelift or MACS lift for droopy upper cheeks

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For me, the high SMAS facelift is the best method for attaining the optimal result in face lifting both for natural contours but also the excellent midface lift that happens along side the face lift. However it would be important that the surgeon is experienced, confident and competent with the technique as the various directions or vectors of the elements of the facelift are the factors that lead to the best outcome. 

A MACS  lift in expert hands can also lead to excellent results but for me there is more generalised control with the high SMAS, and moreover for me also I think improved longevity of outcome.

I hope that this was useful information for you.

best wishes

Tariq Ahmad, MBBChir, FRCS(Plast)
Cambridge 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.