MACS Lift Candidate?

I am only in my 30s but due to bone surgery reducing a long face, my face has become shorter with about 2cm. Very visible sagging on the lower cheeks and at the jowls. Thinking about MACS but concerned that there's just too much soft tissue to lift with this method and will have bumps. A higher cheek wouldn't be bad, but not overdone. Also have infraorbital deficiency for which these soft tissues might be used somehow. What would you suggest? Thank you in advance.

Doctor Answers 7

What about the "MACS" lift type of facelift?

The MACS lift (minimal access cranial suspension) type of facelift can be a very valuable procedure when used in the properly selected patient. Drs. Patrick Tonnard and Alex Verpaele of Belgium were 2 of the surgeons who have helped develop and refine this procedure. The deeper layers of the facial tissues are supported in part to a dense layer of tissue above the cheekbone and this can be as secure as many other more traditional procedures. Not all surgeons utilize all types of "facelift" techniques. And there are many many versions of facial rejuvenation. There are pros and cons of ALL facelift procedures and it is wise for the surgeon and patient to discuss these prior to surgery. 

Louisville Facial Plastic Surgeon
5.0 out of 5 stars 69 reviews

MACS Lift for Suspension of Soft Tissue Descent

   The pursestring sutures utilized in the MACS lift can be altered as necessary to resuspend the tissues in whatever organization is found to be most pleasing.  There is always some irregularity but this can modified some by getting good skin redrape and trimming redundant tissue (fat).  Of course, I dissect thin skin flaps so that the lumps are fat not SMAS or subSMAS structures.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

MACS Lift Candidate -

A MACS lift is a great procedure especially for younger facelift patients. Sagging Skin Not Age is the deterimining factor. Without an examination or at least photos it is impossible to tell if you are a candidate for this surgery.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

MACS Facelift


MACS Facelift is good technique but it must be applied in the appropriate patient.  A picture for this online format would be appropriate.  The most appropriate recommendation would be to consult with a board certified plastic surgeon.


Dr. ES

MACS lift, facelift, and other options

Dear bob,

  • the procedure you are looking for should be tailored to the results you want
  • don't worry about the names because they are just variations of some sort of facelift
  • you may need a combination of volume augmentation (fat or fillers) and lifting to get the results you want
  • When you are serious about all this, please see a couple of plastic surgeons to get a better idea of what your options are

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 reviews

MACS-LIFT GOOD but has some drawbacks

i have seen 2 decades of facelift evolution


the drawback i see is patients complain for an extended period of time about pain while chewing:  the macs lift anchors tissue to the fascia of the muscle used for chewing


i believe many aspects of the macs lift are brilliant, and have adapted them to my present short - incision lift


hats off to the inventors of the macs lift for many of the concepts they have introduced

David V. Martini, MD
Elkton Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

The right facelift for you: the secret is respect the SMAS and customize to patient variation

The MACS lift is the number one most performed facelift technique in this country and this is mostly because it is quick and easy.  I do not perform the MACS lift on anyone because i feel that the centrifugal type forces created cannot achieve a natural looking form.   The second reason I do not perform the MACS lift is because of the vertical skin vector.  A vertical skin vector will always result in strange "Joker lines" as described by Jim Stuzin and Val Lambros.  The short cuts are never worth it.  The best result in a facelift for anyone is always achieved with a well thought out customized SMAS facelift.  I am very progressive in my practice and perform many procedures that few others do, but sometimes the old way is the better way.  Like all surgeons I have my biases and have modified the SMAS lift in ways that work well for me but it is extremely similar in principal to that of Stuzin and those before him.


I would advise you to find a surgeon that you trust that is experienced in a true SMAS facelift.  They are truly becoming rare these days but they are out there!  I hope this helps!



All the best,


Rian A Maercks M.D.

Rian A. Maercks, MD
Miami Physician
4.9 out of 5 stars 75 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.