MACS or SMAS lift - which procedure is best for me? 54 y/o, recent weight loss (photos)

Question

54 year old woman. Recently list 60 pounds. Had a mini-facelift 12 years ago, buccal fat removal 2 years ago. Thinking of having a mini face lift. Advisable? Worry my face will look too "short" given my small chin?

David Hansen, MD · Answer

From the photos, the Advanced MiniLift under local would give such great results and is so easy to undergo.  It fixes the jawline and neck quick and safely.  Never go under general if you can help it. Cost is on special currently for just $15,000 and is so worth it. Also you need the skin resurfaced on the face, neck and probably chest which is easy to undergo at the same time as the minilift since everything is numbed up nicely.  Morpheus and TCA peel together would do the trick for an additional $5000. Then everything would look rejuvenated and great.

Randal Haworth, MD, FACS · Answer

Given your diminutive chin, especially in the vertical dimension, any form of facelift may fall short of your expected goals. An appropriately sized chin would give you both forward and downward support of your soft tissue between your lower lip and chin (in front of the jowls) which will only enhance a Facelift result.

I hope this helps,
best of luck !

I hope this helps,
best of luck !

Bora Ok, MD · Answer

Greetings from Istanbul, and a hearty congratulations on your successful weight loss! A mini facelift seems to be inadequate for your needs. A SMAS lift would be more suitable to correct the sagging in your jowls and neck area effectively. However, addressing the midface would require an additional procedure, with an incision in the temple area to achieve optimal lifting and rejuvenation. Wishing you continued success on your journey!

David Tauber, MD · Answer

Your pictures demonstrate moderate skin laxity of the face and neck that manifests as facial decent, howling, and central neck excess. The chin also demonstrates volume loss - especially of the upper neck. You may be able to get a way with a mini lift, however, I think you will likely need a secondary modified mini face and neck lift with deep plane tightening of the platysma to sharpen the neck. Overall this should't affect the relationship of the chin with the rest of the face and neck. Typically, I do that procedure as part of our Wide-Awake-Surgery program – surgery done under local anesthesia in the office. The same surgery is also available in the OR under anesthesia.

Konstantin Vasyukevich, MD · Answer

We appreciate your question. After reviewing your pictures, it appears that a mini facelift may not achieve the most effective facial rejuvenation in your case. Typically, mini facelifts are recommended for individuals in their 30's and early 40's who exhibit minimal signs of aging. A more comprehensive procedure such as a deep-plane facelift would be more suitable and provide a longer-lasting outcome. This type of facelift can effectively get rid of jowls, tighten the lower face and neck, as well as smooth out the cheeks. We recommend seeking a consultation with a facial plastic surgeon who specializes in facelifts to determine the best option for you. Best wishes! Dr. Konstantin

John Michael Thomassen, MD · Answer

A mini facelift using a SMAS flap or plication of SMAS (equivalent to a MACS) would be ideal.  It would lift your cheeks, efface your nasolabial folds, eliminate jowls, and tighten neck.

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Jeffrey M. Darrow, MD · Answer

Thank you for your photographs and congratulations on your weight loss. Your photo show generalized facial deflation, which would be best corrected with a SMAS lift to maintain midfacial volume and straighten your jawline, as well as smooth loose skin of your cheek and neck, likely more lax due to your weight loss.  Have a detailed consultation with your plastic surgeon about your goals.  Best wishes.

Jeffrey Lisiecki, MD · Answer

A facelift would be a helpful procedure, but a couple of points to discuss.  A SMAS facelift is generally a more comprehensive procedure than a MACS lift, and is my preferred technique for facelifts, especially in the setting of significant weight loss where you have a lot of excess skin on your neck, and in the setting of a revision procedure.  You are correct about your smaller chin, as well, and this can be helped with a chin augmentation at the time of your facelift procedure.  The other thing to consider is the use of targeted fat grafting to restore youthful fullness to certain areas of your face like the cheeks and nasolabial folds.

Andrew Miller, MD · Answer

Based on your photos, you are a great candidate for a lower face and necklift. A mini facelift will not do much for the neck, and I imagine you want this area improved as well. Some fat transfer at the same time can help smooth out the folds at the same time. The result should be nice whether you work on the chin at the same time or not. Be sure to see a facial specialist for consultation.

MACS or SMAS lift - which procedure is best for me? 54 y/o, recent weight loss (photos)

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