The European MACS lift

Traditional facelift techniques reverse changes due to aging in the lower two-thirds of the face. They can effectively turn back the clock without leaving a windswept look. The healing process takes at least three weeks before people are comfortable appearing in public with confidence that the surgery is not noticeable.

While looking for a safe, natural, effective and less invasive procedure with a shorter recovery time, Dr. Press discovered MACS lift -- the Minimal Access Cranial Suspension (MACS)-lift developed by Belgian physicians Patrick L. Tonnard, M.D. and Alexis M. Verpaele, M.D.

The European MACS lift is not a mini-lift. The results from this procedure are comparable to or better than the more aggressive and risky full facelift techniques.

Dr. Press has performed European MACS lift surgery on about 40 patients from 45-76 years old, both men and women -- some having their first facelift, some having a second or third cosmetic procedure. The operation has been combined with eyelid surgery, endoscopic brow/forehead lift, laser resurfacing, and lip augmentation with the patient's own tissues. Patients have been very pleased with the natural, un-operated (non-surgical) appearance and the quick recovery.

The procedure can be used for all patients who are candidates for a standard facelift. In patients with very loose or sun-damaged neck skin, or in most patients over 70, additional work may need to be done in the neck. As with all facelifts, results will be longer lasting in younger patients and those with good quality skin. Unlike other facelifts, the MACS lift may be repeated multiple times without sacrificing natural results as the direction of pull is vertical, not posterior.

Procedure Description:

The European MACS lift is an outpatient procedure that takes about 2-1/2 to 3 hours. If other procedures are added (for example, brow lift or lip augmentation), the length of time will be increased, but it will remain an outpatient procedure.

The procedure is done using local anesthesia and light sedation (twilight sleep) or with a formal general anesthetic. With either method, the patient remains comfortable throughout the procedure and awakens quickly after its completion.

The procedure begins with liposuction of the neck and removal of any fat collection under the chin, working through a tiny incision placed in a skin crease under the chin. In general, only a small amount of fat is removed to improve the neck contour. This will assist in tightening the excess skin in the neck.

The European MACS lift itself begins with incisions in front of the ears extending upwards inside the hairline to the level of the eyebrow. No incisions are made behind the ears. A small area of skin is lifted off the cheek and the underlying SMAS (the fibrous layer that sags with aging, contributing to tired appearing lower eyelids, jowl prominence and loose tissue in the neck) is gathered upwards with three sutures that are firmly attached to strong tissue at the base of the temple. This further tightens the neck, redefines the jawline, and elevates the cheeks to a more youthful position in relation to the lower eyelids.

The excess skin, which has been moved upward because of its attachments to the SMAS, is trimmed at the incision and closed under minimal tension with fine sutures.

The procedure is repeated on the other side.

In most cases, elevation of the cheeks will cause a small roll of excess skin to appear in the lower eyelids. If present, these are removed through nearly-invisible lower eyelid incisions just below the eyelashes. Generally, only skin (not muscle or fat) is removed to avoid a hollow lower lid and to achieve a smooth transition from lid to cheek. These incisions are closed with very fine sutures.

The procedure is now complete. A soft mildly compressive "gauze helmet" dressing is applied but the entire face is free. No drains are used.

Aftercare generally requires only cool compresses to the eyes, mild head elevation, and pain medication, as needed. Pain is generally mild and easily controlled. The dressing is removed the day following the procedure. The patient is allowed to shower and shampoo daily until the sutures are removed. All sutures are removed by 5-7 days after the procedure.

Click to play the video simulation
of the European Macs lift procedure generously provided by
Dr. Alexis M. Verpaele and Dr. Patrick L. Tonnard
of the Coupure Center in Belgium

What To Expect:

Compared to standard facelift techniques, the European MACS lift is quicker to perform, has a shorter incision and a much shorter recovery period (1 to 2 weeks versus 3 weeks for standard techniques). Developed in Belgium in the late 1990's, the European MACS lift has yielded excellent, natural-looking results that have persisted for more than 5 years. It is a pure anti-gravitational procedure with the "lift" directed vertically rather than sweeping back towards the ears. It tightens the neck and jawline and elevates the cheek tissues upwards, restoring a more youthful transition between the cheek and lower eyelid.

It is always combined with liposuction of the neck and can be combined with brow lift (endoscopic or open), blepharoplasty (eyelid surgery),laser resurfacing or other facial cosmetic procedures.

Pre-procedure:

The operation can be performed with local anesthesia and sedation (twilight sleep) or with general anesthesia. It is an outpatient procedure that takes about two to three hours. It is suitable for almost all candidates for facial rejuvenation. Alone, it is an excellent option for young patients with early facial aging changes. Patients with marked aging changes in the neck (a great deal of fat and/or heavy, loose skin) may require additional skin removal.

Post-procedure:

Aftercare is similar to a classic facelift. Dressings are removed in 24 hours and the patient can shower and shampoo at that time. Sutures are removed at 5 to 7 days postoperatively. Most patients can return to work at 7 days postoperatively with the use of camouflage makeup. Normal activities can be resumed at two weeks without makeup.

Click through to before and after pictures