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Face Lift, Neck Lift, MACS Lift

Face Lift, Neck Lift, MACS LiftToday’s facelift goals are to look natural, and not done, or operated. To do that well, the deeper tissue is repositioned before re-draping the skin.

There are different types of face and neck-lifts that are best for different patients. Younger patients will have better skin and may get by with neck liposuction or a neck lift. If the skin is loose, more skin removal is required. A lower facelift will actually tighten the neck skin the most.

Face and necklifts for many patients are not physically hard or painful. Half of our patients report no need for pain medication after just 24 hours. Mentally though, it does take a while. We have had patients look good in just a couple of days, but swelling and bruising among patients varies so some may take weeks. I also have had several patients return to work in 3 days, but we cannot promise that to everyone.

A mini facelift or cheek-lift is good when the neck in not lax or loose. The incision is hidden by hair and follows the contours of the front of the ear. In some cases the cheeks can be lifted through the lower eyelid incision. Other names for mini face lifts include S lifts, weekend lifts, or names that are advertised by large companies. These companies claim exclusive operations by their advertising; however, the American College of Surgeons has always stated that all operations should be open to peer review and not secret. These are felt to be an S type lift. In addition, many of the doctors that do these lifts that are for a specific lifestyle may not have trained as board certified plastic surgeons.

Board certified plastic surgeons, certified by the American Board of Plastic Surgeons, and members of the American Society of Plastic Surgeons are required to do all surgery in a certified operating room. This requires all the appropriate monitoring equipment, safety standards, and training required by hospitals. Our operating room is certified by the Joint Commission.

Our most common facelift is a lower facelift with a MACS component. This tightens the neck and jowls the best. It repositions the cheek fat higher where it looks youthful and natural. Sutures are used (MACS component) to reposition the fat and then re-drape the skin. We don’t want to pull the skin tight and cause an unnatural look.

The MACS can also be done without the neck if the laxity is just in the cheek and then is known as a MACS facelift. The MACS lift can have some neck tightening by the sutures, or by adding an incision under the chin.

The incisions for the lower facelift are hidden by the ear and under the chin. If there is a lot of fat the neck may have liposuction.

If the brow has drooped, or is ptotic, then a brow-lift may be added to the facelift. Another frequent component is upper or lower blepharoplasty (eyelid surgery) done at the same time.

Many patients ask for a necklift. Whether they think a necklift has less negative stigma, or is a lesser procedure, they don’t want to have a facelift. But if there are jowls in the face, loose skin in the neck, and the age is 45 or older, usually a lower facelift will give much more improvement. If they feel better calling it a necklift, that is appropriate, but the lower facelift will actually tighten the neck better as the skin can be repositioned and tightened better. Younger women, with more fat than loose skin, and men, (who don’t seem to mind jowls as much), more commonly will have a necklift.

In the youngest patients neck liposuction alone may be successful, as the skin has enough elasticity to retract and smooth. In those in their 30s and early 40s with good skin tone, a mini neck lift where liposuction is combined with tightening done through an incision under the chin may work very well.

Further improvement can be obtained by later fat grafting to add volume where it is needed. Our most common operation on someone who had a facelift before is not another facelift but fat grafting to restore volume.

“I am completely happy with the results of my surgery. I feel more confident in myself.”
– MACS Facelift Patient
Individual results may vary

Recovery time

A few patients will not bruise or swell much and with hair down, look good in a few days.*

Most patients will look good to strangers by two weeks.*

Most patients will look good to family by four weeks.*

Most patients will feel they look great by six weeks. Because of altered exercise and routine, and recovery, I warn my patients many will feel depressed the second week. My staff is very helpful with reassuring support during that period. The facelift unfortunately cannot make you look like you did at age 30, but can make you look like a more refreshed, less tired version of yourself!*

*Individual results may vary.


Bruising and swelling can last two weeks or longer. There may be areas of numbness in front of the ear. A few percent will have late bleeding called a hematoma, which requires removal. The nerves and muscles to the smile can be injured from the surgery. The vast majority recover but rarely someone’s smile is uneven (facial nerve injury). Perfect symmetry is rarely possible. The surgery does not tighten the lines around the mouth; fillers or fat grafting is needed for those lines. Other rare complications may occur.

I try to recommend the best options for you and to achieve a natural, refreshed look.

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