New Modified MACS Facelift

A new face lifting technique was recently developed in Europe. After spending time with Drs. Verpaele and Tonnard in their Ghent, Belgium operating room, I imported their techniques to the United States. I have been very excited and satisfi ed with the results.

This short scar facelift is not the same thing as a traditional facelift with a shorter scar. Instead, the general principle of this short scar facelift is the vertical suspension of sagging facial soft tissues with slowly absorbing purse-string sutures anchored to the deep fascia of the face. It is called a Minimal Access Cranial Suspension Lift (MACS).

I have adjusted my mid-facelift technique to incorporate the best of each procedure, the MACS and the Composite Lift and I have named it the Modifi ed MACS Facelift. Unlike the highly advertised style lift performed by nonplastic surgeons, this facial sculpting technique has real and lasting changes.

With the modifi ed MACS, the mid-face is addressed as completely as with the full facelift. The difference is in the neck. Before, there was not a successful way to tighten this part of the neck with only a mid-facelift. Now, an angled purse-string suture at the jaw line lifts the neck and the neck muscle (platysma). This hockey-stick shaped suture leaves a slight fullness under the ear lobe, which disappears in one to three weeks. This suture pulls the jowls, neck glands and submandibular bulges. This technique requires honed surgical skills and is not for every doctor.

The original MACS facelift also uses a U-shaped pursestring suture to pull the mid-face and a second set of sutures to smooth out the pull. I have replaced this with the composite facelift going beneath the skin, fat and muscle for a more even result (hence modifi ed MACS). Unlike the full facelift, the modifi ed MACS could be done with local anesthesia but, because of the depth of the lift, I recommend light sedation. Often suction lipectomy of the neck is also performed. The modifi ed MACS is less aggressive than the Full Composite Lift but is still phenomenally effective. This hybrid technique is a shorter procedure with less recovery time.

This new procedure is excellent for younger patients who are even in their 30’s. It can also be applied to older patients in their 50’s and 60’s if the quality of the skin is good and the neck is small. The modifi ed MACS is also a great surgery for patients that have already had a full facelift with their necks treated by plication of the mus-cles and with fat sculpting under the chin. This new procedure, unfortunately, is not good for those with very loose necks where the elasticity of the skin is gone or people with severe neck muscle banding.

In conclusion, the modifi ed MACS gives a superb and lasting result without scars behind the ears, in the scalp, lateral neck or chin. It gives the same natural look that my patients have expected for the last 20 years.


  1. Short-scar facelift: Tonnard, P. and Verpaele, A.M., Quality Med. Pub. Minimal Access Deep Plane Extended Vertical
  2. Facelift, Jacono, Andrews et al. Aesthetic Surgery Journal Vol. 31 (8), November 2011

David Benvenuti, M.D.

355 Placentia Avenue, Suite 104
Newport Beach, CA 92663
Phone: (949) 650-2345
Fax: (949) 650-6817

Specializing in all Cosmetic Surgical Procedures for the Face & Body Board Certified ABPS Over 20 years of experience

Questions & Answers

Q: Is there any bruising?
A: Minimal but some at the lower jaw and neck area.

Q: When can I return to work?
A: 5-7 days.

Q: Do I have any bandages?
A: Yes, a head dressing which is removed the next day.

Q:Do I need a nurse to take care of me?
A:No, but someone must drive you home and stay with you for 24 hours.

Q: How many follow-ups will I need?
A: Day 2 for dressings and day 5 for sutures.

Q: Where are the scars?
A: From above the ear in the hairline, inside the ear, and ending behind the earlobe base.