The Simple and Extended MACS face lifts are mostly performed as outpatient procedures under local anaesthesia with intramuscular sedation. The limited skin undermining of this technique and the fact that the SMAS is left undissected results in a simple and safe technique with minimal swelling and reduced down-time for the patients. A youthful appearance of the face is achieved by remodelling the subcutaneous musculo-aponeurotic tissue with 2 or 3 purse-string sutures in a vertical direction with conservative skin resection and redraping. The social, psychological, physiological and anatomical aspects and differences between male and female patients requiring face lifts surgery should be addressed thoroughly. The MACS-lift has become the workhorse in facial rejuvenation in our practice, both in females as in males. It restores the contours of the neck and lower third of the face and adds volume to the midface through a vertical tissue repositioning, resulting in a long-lasting and natural looking rejuvenation. It is a safe and reliable technique. The incision respects the natural hair-bearing regions, thus resulting in inconspicuous scars and minimal face-lift stigmata. The skin undermining is limited in comparison to traditional face-lifts, resulting in minimal numbness, less flap complications, decreased incidences of haematomas, and allowing for a quick recovery.
Special attention should be given to meticulous and proactive haemostasis in male patients because of physiologic differences in skin vascularisation. Primary Ancillary Procedures performed as adjuncts to MACS lifts sometimes required to optimise the outcome e.g. brow lift, lower or upper eyelid plastic surgery, chin or cheek reshaping.
