MACS Lift: thread under skin?

Jane.   It is my pleasure to provide details and clear up any misconceptions regarding one of my favorite procedures, the MACS Mini-Facelift. Developed in Europe, it is the ideal approach for the younger patient, not ready for a full facelift, or patients who desire a less invasive procedure with a shorter recovery time. Skin incisions are shorter and designed to lift the skin in a more natural upward fashion after undermining. The sutures that you are describing are not permanent but instead made of a slowly dissolving material that goes away within six months. The “loop” sutures are placed deep within the underlying facial and neck muscles, allowing the surgeon to tighten the neck and mid-face regions, improving the result and increasing the longevity of the facelift. The sutures eventually dissolve but the lift is maintained by unobtrusive, deep scar tissue. The operation carries a high level of patient satisfaction. Be certain to consult with a board-certified plastic surgeon. Best of luck.

MACS stands for Minimal Access Cranial Suspension lift. It's a type of facelift that uses shorter incisions (usually around the ear) and internal sutures to lift sagging facial tissues — mostly the mid-face and jawline. Yes, in the traditional MACS lift, the sutures (threads) placed under the skin are usually permanent (non-dissolvable). They're used to anchor and suspend the deeper layers of the face to more stable structures like the deep temporal fascia. These aren't the same kind of threads used in a thread lift . Instead, they're surgical sutures, designed to stay in the body long-term. The thread is placed deep, in the SMAS layer, so it’s usually not close to the skin’s surface. Good surgical technique and patient selection, eliminate to visibility. The MACS lift uses permanent sutures because the goal is long-lasting support of sagging tissues. The MACS lift is about lifting sagging tissues back to their youthful position. But yes, as the soft tissues are elevated, it can give the appearance of a fuller mid-face, especially around the cheek area.

There are advantages to each type of thread.
The loop thread can be a permanent thread or a thread that takes a long time to absorb. That decision is one that your surgeon makes. Personally, if I have a patient with very thin skin, I use a thread (surgically known as a suture) that will last long but will absorb and disappear over time. By the time the thread is gone, the tissues will have healed into their new location and the thread is no longer necessary. I do this because I don't want my patient with thin skin or I to be able to see or to feel the thread.
If I have a patient with a very heavy face, and thick skin, I use a permanent thread. I do this because the thread will be covered very well with the thick tissue and it is unlikely that we will be able to see or feel it and I feel that holding the tissues with the suture longer is beneficial for a heavier face.
One advantage of the MACS style facelift is that is can adjust the deeper tissues to make them look fuller, however, how well that works depends on the face you are working on.
I recommend you ask your surgeon what their approach is to selecting the best suture for their patients.
All the best to you,
Dr. Nancy de Kleer

Thank you for the question, The MACS ( Minimal Access Cranial Suspension) lift is a technique develop by two surgeons in Belgium. It utilizes sutures to lift and support the facial tissue from a stable spot in the temple. The original technique called for permanent sutures but now most surgeons use absorbable sutures for the lift. Those usually dissolve in two-three months, after everything has healed. I have used this technique many times since it was originally presented at the international conference I chaired years ago. It is an excellent technique in the hands of an experienced plastic surgeon, with extensive experience in facial surgery. I hope this helps. 

I appreciate your concerns since trying to understand all of the different types of FaceLifts that are describes is more than difficult. All Face and Neck Lifts tighten and elevate the deep tissues with sutures. The sutures are placed within the deep tissues ie:buried within the muscle\fascia not directly under the skin. The sutures dissove as the tissues heal. 
The MACS Lift is different from other types of lifts in that  instead of the deep tissue being held by only a few sutures placed in soft tissue, the MACS places multiple sutures in the deep tissue and then lifts and anchors this to the bone and facia. This is much more secure and longer lasting..

A macs lift typically places two absorbable sutures in the tissues above the muscle. The result is a lift to the neckline and cheek jowls. As the sutures are dissolved the result is maintained by the natural healing process.   The best candidates are those with just the beginning of  cheek jowls and neck skin laxity.