Can poorly placed MACS lift/ facelift scars cause skin sagging or is this due to tissue damage? Loss jawline definition. (photo)
Doctor Answers 14
Bad facelift scar.
MACS Facelift Scars
In a short scar facelift such as the ‘S-lift’ or ‘MACS’ lift, the skin excess removal is transferred from behind the ear to the area in front of the ear at the visible edge of the temporal hairline (sideburn), where it is much more challenging to deal with significant skin excess in a manner that is aesthetically acceptable. The excess is generally gathered around the sideburn area, leaving a wavy, pleated scar in a very visible location. The result one should be attempting to achieve in facelift surgery includes scars that are difficult for even a hairdresser to locate. Irregular scars in the sideburn area are a dead giveaway that a patient has had a facelift.
The reality of the ‘short scar’ facelift is that if one is talking about visible scars, then the scars aren’t any shorter than those that are created by a surgeon using expertly-planned and carefully performed traditional facelift incisions, and they tend to be more easily visible as skin excess is treated in front of the ear and sideburn.
Limiting the skin excision to the area in front of the ears and sideburns also creates problems in the neck. Look at numerous ‘before and after’ photos of patients who have undergone ‘short scar’ facelifts. In the patients who have jawline and neck skin excess preoperatively, you will almost always see unnatural appearing vertical skin folds in the lateral neck below the ear, and limited improvement in the definition of the jawline and neck in profile. If a facelift surgeon does no work with the skin behind the ear, then he/she severely limits their ability to improve the skin contour of the lateral jawline and neck.
The proof is in the pictures. Look at as many ‘short scar’ before and after photos as you can before proceeding. And check to see if the surgeon is using their patients’ hair - especially the sideburns - to conceal their patients’ pre-auricular (in front of the ear) scars.
Unhappy with MACS lift
I am sorry you are disappointed with your result.
- It may be possible to revise these scars.
- I have seen this problem with other MACS lifts -
- this face lift relies entirely on very tight sutures which distort underlying tissues.
- As the suture pull subsides, tissues shift.
- So you may be correct that the tissues no longer seem to be in the right place/
Hope you find this information helpful. Best wishes.
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Poor scars after a facelift are unacceptable.
Please see a board certified Plastic Surgeon specializing in facelifts.
A Good Facelift Never Pulls Skin
Sometimes the "minimally invasive" techniques that promise just a little something - no major surgery, are a bad idea. In my practice, I ALWAYS elevate and advance the SMAS because if I don't, the results don't seem to last. Then I did all that work for nothing!
Revision Facelift needed
MACS Facelift sorrows
Various options for facelifting are available according to the skin laxity, soft tissue sagging and areas of lift or tightening you wish or need.
Generally, the more skin there is to remove and tuck, the longer the incision. If the incision is shortened, the excess bulge of the skin will redrape downward and may explain the " slacker tissues and less defined jawline" you have questioned about. The more soft-tissue and fat lifting required, the more skin (flap) needs to be elevated in order to reach and suspend these tissues.
The recent resurgence of the S-Lift (created in the early 1900's), has been modified into a 2 layer lift and called by other names as the Quick-Lift, Lifestyle-Lift, Swift-Lift, Soft-Lift, MACS-Lift and others. They are a single modification of the S-lift targeted to elevate sagging lower cheeks jowls and lateral upper neck. The shorter scar, limited undermining and second layer lift achieve the "quicker" procedure but not necessarily the quicker recovery or the improvements you desired.
Thank you for sharing your photos. The scars noted are a variation of technique that do not do justice to hiding them behind the tragus (cartilage protrusion in front of the ear canal). A longer incision properly placed behind the ear will assist in redraping the excess skin left along the jawline. Undermining the neck and placing a suspension suture across the neck (with or without neck platysmaplasty) will help to suspend the soft tissue descent of the neck and provide a crisper appearance.
All of these concerns may be re-addressed with your surgeon or a 2nd opinion with a well experienced Board Certified Plastic Surgeon or Facial ENT.
I hope this has been helpful! All the best!
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.