Please Describe the Short Scar Facelift

A doctor mentioned a short scar facelift. Please describe this procedure and how is it different from a traditional facelift? Also, is it true that in a traditional facelift, they actually lift the skin and re-drape it after stapling underlying tissue? Is it true that they have to put screws in the skull as well? Please explain this procedure.

Doctor Answers 28

Short Scar Facelift

Traditional Face Lift, MACS or Short Scar Lift: What's the Difference
The differences are significant. The idea of a facelift with a ‘short scar’ appeals to the consumer, but the term is quite misleading. It leads one to believe that you can get the same result with a shorter scar, and the reality is that you can’t. It sounds too good to be true, and it is. In fact the logic behind these procedures really defies logic.
Short scar???

The ‘short scar’ and MACS facelifts eliminate the incisions behind the ears, which – if carried out correctly – should result in invisible scars. Scars behind the ears, when placed where they belong (in the depth of the crease behind the ears and hidden in the occipital hairline) are either invisible or very difficult to detect. So why all the fuss? Because a lot of surgeons are not meticulous about making and closing the incisions behind the ears, which has given these scars a bad name. But there is no reason it has to be that way.

Hey, what are those odd scars in front of your ears?

The MACS facelift moves ALL of the skin excision into the area in front of the ear, which forces the surgeon to create a gathered, pleated and essentially impossible-to-conceal closure around the patient’s sideburns. With a traditional facelift closure the scar in this area may be placed behind the temporal hairline, where it is invisible, or at the hairline, where it can be closed invisibly because much or most of the skin excess has been removed behind the ears.

The MACS lift does something that is completely counter-intuitive: moving the surgical scars from areas where they are easily concealed to areas where they are almost impossible to conceal. The term ‘short scar facelift’ is really misleading, as you go from longer scars that can be completely concealed to shorter scars that can’t. So effectively, in terms of visible scars, the ‘short scar’ facelifts are in reality LONGER VISIBLE SCAR facelifts.

They are also - as they undermine less skin and undertreat or completely fail to treat neck skin laxity - less of a facelift. And not really a necklift at all, which all facelifts should be.

Um, your neck still looks old.
There’s just no way around it. In patients with neck skin laxity, if you fail to fully mobilize the skin of the neck as well as below and behind the ears, then it is physically impossible to create a smooth, dramatic and truly rejuvenation neck contour. Unless, as a cosmetic plastic surgeon, you are willing to leave a pile of skin folds and pleats in the lateral neck below the ear. I have yet to meet the patient who will be happy with a sort-of youthful anterior neck but an aged and post-surgical looking lateral neck. And I would derive no joy from providing a patient with that kind of surgical result.
Spend some time carefully studying ‘short scar’ facelift (‘MACS lift’ ‘S-lift’, ‘weekend facelift’, ‘Lifestyle Lift’, etc.) before and after photos. You will see, over and over, the following features:
Easily visible scars in the sideburn area and in front of the ears
Distortion of normal sideburn anatomy
Gathering of skin (pleats and wrinkles) below the ears
Undesirable skin contours below the jawline and in the neck
Little to no improvement in neck skin laxity
f course you may also see unfavorable scars in traditional facelift ‘before and after’ photos, so you need to carefully research the physician or physicians you decide to consult with for a facelift procedure. If a surgeon has mastered the High-SMAS face and necklift procedure, the scars should be close to invisible and often undetectable. This procedure, combined with structural fat grafting, rejuvenates the face in a very dramatic yet still very natural-appearing way. And with scars that allow a patient to wear their hair any way they please, including pulled back in a ponytail or gathered up above the ears.


Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 110 reviews

The scar war

A short scar face lift is a face lift that is performed through a small scar( less than the traditional pre-auricular/ post auricular incision).

Short scar surgery became very popular in the late 1990 and is obviously very tempting. Endoscopic techniques allowed some of these surgeries to performed with very small scars e.g forehead lift.

It became clear after few years that the success of these mini lifts depends on the patient anatomy and the degree of sagging.We performed a study in 2002 looking at 200 face lifts, this group showed an improved benefit of short scar technique in the group of patients with less degree of tissue aging and in general younger patients.

My recommendation is to let your surgeon access you tissues and decide what would be the best procedure for you. Best of luck!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Short Scar Technique Is One of Many

As its name suggests, a short scar facelift involves a limited incision. With limited incisions comes limited access to the underlying tissues of the face and neck. A good candidate for a short scar facelift has good skin tone and elasticity and is seeking improvement to the jawline or neck only. In my opinion, one of the keys to a good facelift is not necessarily the length of incisions — it's placing them as inconspicuously as possible. Discuss your options with a qualified plastic surgeon who specializes in facial plastic surgery. 

Marc DuPere, MD
Toronto Plastic Surgeon
4.8 out of 5 stars 60 reviews

What is a short scar facelift?

Any technique that promises shorter scars or 'scarless' surgery tend to attract patients. However, perhaps a more practical question is 'who is a candidate for a short scar facelift?' In cosmetic surgery, the secret to success is executing the appropriate treatment in the appropriate candidate. Rarely is an individual patient an ideal candidate for every technique. 

That being said, the best candidates for a short scar facelift are patients with minimal excess skin and essentially no neck or jowling problems. As you can imagine, this is a small population. 

I recommend a formal consultation with a board certified plastic surgeon so your goals can be discussed and an exam performed so an individualized recommendation be made. Good luck!

Short Scar Facelift

Short scar facelift has its place in the aging face surgeon's tool box.  The key here is to determine if you are a proper candidate for such a lift.  The scar provides access to the face for the lifting portion.  In some patients, especially those with a large amount of neck skin, the short scar lift may not be the best option.  

While the short scar provides access to the face, the underlying technique of lifting the face should still focus on lifting the deeper tissues of the face into a better position.

For more information on short scar lifts, see link below.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Short scar facelift is limited in the extent of the incision and amount of dissection

There are many different variations of a short scar face lift. This approach differs from traditional face lifting approaches by the limits in the length of the incision, the depth of incision, the amount of dissection, and extent of improvement. It really depends on who you go to. There are ways to limit the length of skin incision and still achieve amazing results through tissue distribution.

Many surgeons out there are making the short scar facelift more a "short cut" face lift where corners are cut and the results are essentially much less satisfactory. However, there are some very knowledgeable surgeons out there that can use a short scar and do amazing things. Short scar facelifts usually entail also superficial dissection to avoid exposing facial nerves and is deemed safer by many.

Thanks for reading!

Philip Young, MD
Bellevue Facial Plastic Surgeon
3.9 out of 5 stars 64 reviews

Short scar facelift usually means short recovery time

Short scar facelift has become in increasingly popular facelift alternative in recent years and sometimes is referred to a s soft lift, or an 'S' lift. These descriptions are meant to describe the short scar which runs around the side burn and down to the earlobe, a kind of S shape. Through the short opening there is enough room to raise up the deeper tissues and rejuvenate the face, neck and jowl. This should not be confused with 'thread lifting'.

The short scar facelift or mini lift can produce substantial and lasting improvement for appropriate candidates, and has the advantage of a short recovery time as well. Because the incision and operation is shortened there is less swelling and bruising and recovery can be shortened to several days rather than a week or longer. The short scar facelift works well for individuals with moderate laxity in the neck and jowl.

Age, in fact, is not the limiting factor as we all age differently, though a very loose neck, a dreaded turkey neck, will most often require the full facelift approach. The full facelift differs in that the incision runs up behind the ear into the hairline in back which allows a very full correction of the neck when needed.

The key to facial rejuvenation is safety, substantial improvement, with a manageable recovery, and in this day and age a short recovery is a must.

Best of luck,
Peter E Johnson MD

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 40 reviews

About Facelift Surgery

A #facelift is a surgical procedure designed to remove the major folds and wrinkles that form on our faces with age. Gravity, sun damage, smoking, living in a dry climate, and a variety of factors contribute to the aging process of our faces. Facelift techniques vary from patient to patient to give each person a procedure tailored to produce the best possible surgical result. A facelift will smooth out major folds and #wrinkles, #tighten the tissues beneath your skin, remove #sagging and excess skin. A facelift can also reduce excess skin around the #neck and #jawline. 

There is not just one facelift procedure, but a whole range of facelift procedures. These different techniques have been developed over the years, involving different incisions and lifting the skin to varying degrees. A facelift may also involve the tightening of certain muscles and tissues, or liposuction of areas such as the jowls or chin.
It is important to understand that facelifts are meant to remove major folds and wrinkles, not fine wrinkles. A facelift which removes every line and fold would be too aggressive and would result in an unnatural result. Fine lines and wrinkles are better addressed by skin treatments such as chemical peels or microdermabrasion, which we also offer at our office.

Incisions vary depending upon whether the patient is male or female, the hairstyles, hairline, age, previous surgery, and other factors. Generally, the #incision starts in the temple, in front or within the hairline. It continues in front of the ear, sometimes partially hidden within the ear. It then goes under the earlobe, behind the ear fold, and ends within the hairline or at the hairline behind the ear. The newer, shorter scar #techniques, which do not include scars in or by the hairline, can be used for most patients. Frequently another small and hidden incision is made under the chin in a natural skin fold. This allows fat removal and tightening of the platysma muscle in the neck if required.

During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Short Scar Lift

Thank you for your question. Short scar lift/mini facelifts, like many facelifts, are done under local anesthesia and are performed by creating an incision in the back of the ear towards the earlobe. They, however, merely address the skin, rather than the underlying muscle tissue (SMAS layer of the skin), meaning that the results typically last for a maximum of about a year (the usual recovery time is about 2 weeks). 

Ramtin Kassir, MD
New York Facial Plastic Surgeon
4.6 out of 5 stars 127 reviews

The short scar facelift

The term 'short scarf facelift' refers to techniques originated with the S-lift and subsequently the MACS lift. It does not make any reference to the exact technique used within the face but refers to the positioning and length of the scar. In a conventional facelift, a U-shaped scar is placed around the ear, both in front and behind. Short scar facelift technique dispenses with the need for the portion behind the ear and is generally used in younger patients and those for whom a neck lift is less of a priority. The exact indication for the technique depends on surgeon's preference and patient wishes and expectations. This should be discussed at length with your surgeon.

James Murphy, FRCS(Plast)
Manchester Plastic Surgeon
4.8 out of 5 stars 89 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.