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MACS Facelift

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MACS-Facelift (Minimal Access Cranial Suspension) is a procedure that leaves you looking fresher and youthful. People may not notice that you have had surgery, just that you look refreshed. The MACS-Lift helps to remove excessive jowling around the chin, deep creases that appear between your nose and mouth, and restores the outline of the jaw. The MACS-Lift is less invasive than other facelift procedures and leaves a shorter scar. This type of facelift will lift and hold up sagging tissues in the neck, cheeks, chin, or near the nose with suspension sutures in the deeper tissues. This operation is done on an outpatient basis while you are under local anesthesia.MACS FaceLift provides natural rejuvenation with shorter operative time, quicker recovery, and less potential for complications compared with traditional face lifts. Fat grafting and Blepharoplasty can enhance the final result.

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MACS Facelift

  1. 1. MACS LIFT for Facial Rejuvenation Stamatis Sapountzis M.D. China Medical University Hospital
  2. 2. Clinical Cases
  3. 3. Patient 1
  4. 4. Patient 2
  5. 5. Patient 3
  6. 6. Rhytidectomy remainsthe “Gold Standard” in facial rejuvenation
  7. 7. 1907 First Anti-aging procedure by Miller He was eradicating wrinkles by subcutaneously sectioning the facial muscles and use paraffin for volume restoringHistory
  8. 8. Cutaneous Period (1900-1970): Eugen HöllanderSMAS Period (1970-1980): Tord SkoogDeep Plane Period (1980-1991): TessierVolumetric Period (1991-today) surgeons started to care more about minimizing scars, restoring the subcutaneous volume that was lost during the ageing process and they started making use of a cranial direction of theHistory “lift” instead of posterior.
  9. 9. “Mini” Face Lifts have gained popularity + -
  10. 10. MACS lift (Minimal Access Cranial Suspension) • Introduced by Tonnard and Verpaele in PRS in 2002 as a modification of a previous described mini lift “S-Lift”) • It combines the advantages of a mini face lift with the effectiveness of more invasive techniques
  11. 11. Traditional MACS In MACS-lifting, the horizontalIn traditional facelifting, an oblique vector is component of the lifting is avoidedused for redraping the skin, which can be as much as possible to create andecomposed into a vertical and oblique antigravitational lifting of the facialcomponent features.
  12. 12. Column 1: Full Incision with SMAS Plication Column 2: Short Scar Incision with SMAS Plication Column 3: Short Scar Incision with MACS3 different face-lifts in Triplets
  13. 13. PRS, 200682 patientsEvaluation:1 and 24months • Shorter operating time • More post-op pain No difference in the cosmetic results
  14. 14. Surgical Technique(MACS Lift)
  15. 15. Skin Marking• Starts at the lower limit of the lobule, going up in the preauricular crease• Incisura intertragica, the marking makes a 90-degree turn backward• posterior edge of the tragus toward the helical root• follows the small hairless recess between the sideburn and the auricle, turns downward to follow the inferior implantation of the sideburn
  16. 16. Solution • 100 ml 0.9 % NaCl • 20 ml 2% lidocaine • 10 ml 10 mg/ml ropivacaine • 2 ml 8.4% sodium bicarbonate • 0.2 ml 10 mg/ml Adrenaline • 10 mg triamcinoloneinflitration
  17. 17. • 3mm cannula • Two or three incisions are used to crisscross the marked area optimally • preplatysmal plane • A maximal lipectomy is performedNeck Liposuction
  18. 18. Incision into hair An incision parallel to the hair shaftswill produce a scar at the border of thetemporal hairline.An incision perpendicular to the hairshafts will produce hair regrowththrough the scar into the cheek flap.The final scar will be hidden a fewmillimeters within the hair-bearingtemporal skin and will be less visible
  19. 19. A limited skin flap is undermined in an oval area extending from 1 cm above the zygomatic arch to the mandibular angle caudally and about 5 cm in the anterior directionSkin Undermining
  20. 20. Anchor point
  21. 21. Frontal Branch of Facial nerve
  22. 22. 1st Suture: U- shape to the mandibular angle and the platysma 2nd Suture: O – shape follows the anterior border of the skin undermining 3rd Suture: U-shape from the lateral orbital rim to the malar fat padPlacement of sutures
  23. 23. Skin resectionThe correct vector of skin redraping isvertical. There will be no dog ear aroundthe earlobe, and a small dog ear at thesuperior edge of the incision can becorrected by extending the incision for 1cm.
  24. 24. The temporal hairlineincision is mandatory in anyvertical face lift technique toavoid unnatural raising ofthe sideburns.No skin resection in thepreauricular region.After vertical redraping ofthe skin flap, the earlobewill be folded upward, and asmall skin excision is madeto place the earlobe back inits natural position
  25. 25. When the skin of the neck is very looseand wrinkled because of excessive sundamage, vertical folds may appear inthe infralobular region at the end ofvertical skin redraping
  26. 26. (A) a zigzag incision is performed just within the occipital hairline. (B) The skin flap is created by blind dissection at a superficial subcutaneous level. (C) The skin is redraped in the occipital direction, and the skin excess is determined. (D) Skin closurePosterior Cervicoplasty
  27. 27. Literature Review about the complications after incisionless lifting with threadsThe complication rate ranges from 2.8% to 69 %2011, Sulamanidze: 609 complications occurred for6,098 patients 3% asymmetry 2.8% contour irregularities in 2.8 % 2.7% early relapse
  28. 28. Thankyou

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