Facelifting (Rhytidoplasty) - Facelift Surgery - Sydney & Wollongong Clinic

It surprises me that so few surgeons perform the short scar vertical facelift (the MACS Lift), as this procedure gives a very natural result with the least visible signs that a facelift has been performed. In addition, the scars are usually very minimal hardly noticeable and the healing is fairly quick with downtime being only in the region of two weeks.

The MACS Lift is minimally invasive and can remove up to 10 years from a patient’s face. It focuses on the lower part of the face and neck and on its own makes a dramatic difference to a patient’s overall appearance and self-esteem.

Fat injections are a very good adjunct to the MACS Lift and if a lower blepharoplasty (eye lift) needs to be performed at the same time, often an extended MACS Lift is warranted. However, if the lower eyelids look very good I resort to performing a normal MACS Lift with the addition of some fat injections to the cheeks and often the lateral and medial brow areas.

In a few people a classic facelift gives a better result, but these patients are few and far between. It is appropriate when there is an excessive amount of loose skin, thus requiring this type of facelift to be performed.

The normal MACS Lift is usually combined with some form of neck adjustment, whether it be liposuction to the submentum or if there are platysmal bands with a platysmaplasty (neck lift). If there are some lower neck issues, an additional scar is placed in the posterior neck hairline, where undermining and taking out skin in this area can improve the lower portion of the neck.

History of facelifting (rhytidoplasty)

Descriptions of facelifts date back nearly one century and were very different to the procedures we use today. They started with skin only lifting and very little skin undermining. A skin undermining face lift was the only method known in the middle part of the twentieth century until an article by Mitz and Peyronie in 1976, describing the SMAS (superficial muscular aponeurotic system) layer, was published.

It was after this time that a description of a combined skin undermining, as well as a SMAS undermining and tightening was described. This led to different types of SMAS undermining and SMAS plications, as well as a composite facelifting technique, which encompasses the skin undermining and the SMAS undermining in one single layer.

Sub-periosteal facelifting similarly gained popularity in 1980’s and 1990’s. This form of face lift lifts the entire integument of skin, subcutaneous fat and muscle off the bone and repositions it. Recently facelifts are progressing towards shorter scars and facelifting encompassing the mid face.

Classically the facelift encompassed improvement of the lower face which is the naso-labial folds, the jowls and the neck, leaving the periocular (eye) area and mid-face or mid-cheek without any change whatsoever.

Newer techniques have encompassed this approach and these techniques are still evolving. The shorter scar facelifts I believe, will gain in popularity.

Post-operative generalisations

Immediately following surgery you will have some swelling to the lower face and neck area. I recommend that my patients sleep in the upright position for the first 5-7 days following surgery to help reduce the swelling. Most patients return to work after 2 to 3 weeks.

A few final words

Whilst the effects of the MACS Lift are long lasting, the effects do depend on the patient’s lifestyle, genetics, and sun exposure and skin care routines. Also, you must remember that a facelift does not stop the normal aging process, but the results of the MACS Lift should last for up to 8 to 10 years.

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