Dr. Dean Kane Q & A.
Q. Six months after my MACS facelift I was unhappy with the result. I didn’t feel it was tight enough and where I wanted to be as pre-discussed with my plastic surgeon. He agreed to redo the MACS lift but I was left with a fold. I later had a small correction under local to try and correct the fold. This all seemed fine but now the scar has rolled out of the tragus and I have another fold with a pulling sensation. I am concerned as what can be done as it looks and feels wrong.
A. Surgical lifts would be likened to pulling the bedspread and / or top-sheet of your bed up to the head-board and removing the excess material.
If your bedspread is too lax for the incision, darting and pleating are necessary to distribute the skin excess. Within the incision, larger darts are removed in triangles leaving a line-scar. At the ends of the incision, the extra skin pouch is often called a “dog ear” and the incision will need to be lengthen in order to get rid of it. . This seems to be what I see in your photos.
The recent resurgence of the S-Lift (created in the early 1900’s), also called by other names as the Quick-Lift, Lifestyle-Lift, Swift-Lift, Soft-Lift, MACS-Lift and others; are a single modification of the S-lift targeted to elevate sagging lower cheeks jowls and lateral upper neck. The shorter scar, limited undermining and second layer lift may achieve the “quicker” procedure and therefore less cost but not necessarily the improvement you desire. See: https://drdeankane.com/mini-facelift-baltimore/
In decades past, the skin was pulled taught with less lift on the underlying soft tissues. Current best techniques will use the SMAS or fascial layer under the skin to lift and re-suspend the sagging soft tissues of the fat and muscle system underneath. The widely undermined skin will be redraped over the tighter, lifted quilting underneath to provide a soft and natural appearance without the pulled, wind-swept look of yesteryear.
You will need a longer incision, typically placed in the crease behind your ear with a new lift of the skin to achieve your goals.
Ask your surgeon if this is within his / her skill level or consider a second opinion consultation with a well experienced, Board Certified Plastic Surgeon or ENT Facial Surgeon to revise your facial skin excess.
I hope this was helpful. All the best!