Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding MACS Versus M.A.D.E. Versus Other Secondary Facelift Options

Patient at the Center for Cosmetic Surgery & Medi-Spa

Q. Why do doctors suggestion MACS Lift for a secondary procedure? I had a Sub Smas face lift. It is mild sagging skin around mouth and jowl which it is not successful. Why Dr choose MACS lift even it is last for 5 years after Sub Smas face lift? MACS lift may last for 5 years. Long Loop sutures is bothering me so much. Loop sutures can make ripple skin, uneven lift, bulge, ridge and etc. I compare MACS lift and M.A.D.E lift. M.A.D.E lift sound better and last longer because it is part of Deep Plane.

A. Thank you for this most interesting question!

The simplest answer to your question is “Surgeons (generally) perform what is best in their hands” based on talent, education and experience.

Beginning in 1901, an ellipse of skin in front of the ears called a “C” lifted the tissues of the sagging cheek. This quickly evolved to the S-Lift which was then adopted with the elevation of the deeper muscle tendinous tissues such as the SMAS (by Skoog) in the 1970’s and the Deep Plane (by Hamra) in the 1980’s.  Most recently, various surgeons have marketed their own “faster styled” facelift such as the  Quick-Lift, Lifestyle-Lift, Swift-Lift, Soft-Lift, MACS-Lift and now you have introduced me to the M.A.D.E. lift. I have explored Dr. Jacono’s website where he explains the M.A.D.E. lift as a “mini” deep plane lift whereas the MACS lift by Tonnard and Verpaele is a “mini” SMAS lift using looped sutures.

I find that most patients come in for a face and/or neck lift when facial skin excess occurs along the marionette fold and jowl or neck. If you can “pinch more than an inch” along the jawline, there is no non- or minimally invasive option to tighten the skin and skin redraping when excision of skin excess is required. Before that point in time or following a face and neck lift when there is less skin excess, a MACS or M.A.D.E mini-facelift may be helpful. Again, your point in aging, weathering, hereditary skin and many other factors will contribute to the duration of these lifts. Since the MACS lift is more superficial, you may see more of the skin rippling and bulging early on as you mention. The M.A.D.E. lift being deeper (I have no experience with this technique) may provide for a smoother early result.

Comparative twins studies of the MACS and Deep Plane techniques have found no difference in results nor duration.  

Let’s not by-pass the newest evolution of minimally invasive techniques including:

ThermiTIGHT

Silhouette suspension InstaLift

Sculptra

As I started with this inquiry, this is a great question in the evolution of facelifting. There are many factors to consider for your individual desires so consider more than one consultation from experienced Board Certified, talented and skilled Plastic Surgeons and Facial-ENT’s for their evaluation and recommendations.

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

Give us a call at  410.602.3322  or email Lauri@DrDeanKane.com and make an appointment soon. We’re located on Reservoir Circle just a block off the Baltimore beltway, convenient to greater Baltimore, Annapolis, the Eastern Shore, Southern Pennsylvania, Delaware and Carroll County.

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