Is There a Serious Risk of Cheek Bumpiness After a MACS Facelift?

I am not a tremendous fan of the MACS Facelift in most circumstances, but would definitely recommend against it in the setting of a thin face.  In my experience, the "purse string" of the MACS lift lack durability in aesthetic effect.  It's a procedure that is designed more for Surgical speed and more moderate aging indications than a typical SMAS procedure.

The #healing process in general can take up to one month for the majority of swelling to subside, incisions to close, sutures to come out, and for bruising to completely go away. #Recovery time from a #facelift varies from person to person, but patients can generally expect to be presentable within three weeks from surgery. Patients should expect swelling, bruising, and discoloration of the skin during this phase of recovery (swelling normally goes down after 48 hours; most bruising will go away within two weeks). Some degree of firmness or #lumpiness under the skin is normal after surgery and will resolve with time. Local #massage will speed resolution of this problem, which normally takes 2-4 months to disappear completely.The marks from a facelift can easily hidden with “camouflage” make-up which you can learn how to apply.The scars from a facelift mature within six to twelve months from the surgery date. It is during this time that the rejuvenating effects of the facelift will become apparent and the real result will be seen.  As with all #cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical #procedure and #revision, there are some risks of unhappy outcome or other complications which your surgeon should discuss with you during your consultation. Your procedure should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for another revision surgery.

There are many nuances of each type of facelift. I think the MAC procedure is an excellent one for a secondary facelift. In my hands the Lite Lift is a modified MAC facelift where I use in addition to the purse-string suture an absorbable suture to make sure that the surface is completely smooth. This has prevented visible bumps and lumps that can be visible in those with "thin skin".The best advice I can give you is to choose your surgeon wisely. Great surgeons usually get great results !

   MACS facelift involves pursestring sutures, which elevate the deeper tissues.  The sutures can create lumps and bumps and are more noticeable in patients with thin skin.  Other techniques may be more appropriate.  Find the plastic surgeon with ELITE credentials who performs hundreds of facelifts each year.  Kenneth Hughes, MD Los Angeles, CA

The Technique of MACS lift involves gathering up the SMAS layer with sutures in order to tighten it. This technique by necessity creates some lumpiness in the deep layer that can be seen through the skin. Patient with thick skin well see this less than those with thin skin. The Sutures can be dissolvable if the surgeon prefers so this usually resolves. Other techniques can cause less of this lumpiness so if you have thin skin discuss your concerns with your surgeon.

The MACS lift has become en vogue the last few years.  It is a simpler facelift and requires less anatomic knowledge than a deeper plane lift.  The main issue with a MACS lift is that the skin is separated from the SMAS layer and then a suture attempts to purse string the SMAS and lift it with a permanent suture.  This has been changed to a longer lasting suture by some surgeons.  The issue is that the deeper tissue is not been lifted but rather gathered so it is very common to see uneveness early after this lift and not uncommon to see asymmetries afterwards.  

The bumpiness you refer to is likely due to non-absorbable or permanent sutures used for the facelift and is easily avoided by using absorbable or dissolveable sutures. The original MACs lift was described using permanent sutures but now the technique is suggested with an absorbable suture, so that should be one less think to worry about... even if it did occur, it is usually caused by the knot on the suture and that can always be cut out after a few months without affecting the results of the procedure. 

I do not recommend the MACS lift in thin face patients.   As you have pointed out, the pursestring suturing is prone to bunching, causing an unnatural bumpy appearance in the thin face.    As a revision facelift, I would encourage you to undergo a SMAS plication with wide undermining.    Revision patients typically do not swell and bruise to the same extent as the primary procedure.

I recommend that you consult with 3 board certified plastic surgeons to help you make the most educated decision.

 

I wish you a safe recovery and amazing result!!

 

Dr. Gill

Your consideration of a MACS lift to refresh your previous facelift is a very good one. 

Every face lift can cause some lumps and bumps under the skin which resolve in time.

You refer to the suspension suture knots which can be felt in front of your ear and next to your eye. With "non-absorbable" suture material it could be a problem but  was most often avoided in "covering" the knots with some tissue oversewn with absorbable sutures. I had to remove some knots after a few months through a small incision in the office without any further problems.

I started to use absorbable sutures a  few months ago which disolve after a few months and have  been very pleased with it.

It is very common to have early cheek bumpiness after a MACS lift...this generally goes away as things heal but may take several months depending on the patient...fat grafting may be an option later if the lumpiness did not resolve on its own, but I have not needed to use this as the deep sutures that I use are absorbable....the original MACS technique used non-absorbable sutures.