Advantages and limitations of the MACS lift for facial rejuvenation.

[INTRODUCTION] Minimal access cranial suspension (MACS) facelifts provide the potential advantage of less invasiveness with quicker recovery. However, there is deficient literature documenting its usefulness and limitations.

[PURPOSE] This study aimed to evaluate the MACS lift for effectiveness in facial rejuvenation.

[METHODS] Institutional review board approved record review of all facelift patients treated August 2006 to October 2011 by a single surgeon.

[RESULTS] Eighty-eight facelifts were done, 8 conventional and 80 MACS. Average age was 59 years with 97% being women. Average body mass index and American Society of Anesthesiology classification score were 25 and 1.6 Kilograms per meter squared, respectively. The only significant complications noted were 3 hematomas that required drainage: all in the MACS group (3.41%); and 1 temporary buccal branch paresis. Other facial procedures were done on all the conventional patients and 59 (74%) of the MACS patients. Notably 8 (10%) of the MACS patients had a nonfacial procedure done concurrently. Average operative times were significantly longer for the conventional lifts at 4:03 compared to 2:39 for all the MACS lifts (: -0.002); 2:05 for MACS alone. Follow-up averaged 6 months (4 to 49). Average return to work in the MACS group was 2 weeks. All conventional lift patients had a high level of satisfaction. Of the MACS patients, 3 expressed disappointment due to residual facial skin laxity or inadequate neck contouring.

[CONCLUSIONS] MACS lift is effective, providing a high level of patient satisfaction due to aesthetic results, combined with rapid recovery and return to normal activities. Compared to conventional facelift, the reduced operative time makes concurrent nonfacial procedures more feasible. Effectiveness has limitations in those with marked skin laxity and/or marked cervical lipodystrophy.