Overview
Many patients want facial improvement without long recovery or high complication risk. The authors adopted the S-lift, which suspends sagging tissue with a permanent purse-string suture, and modified the incision, the anchor point and the skin removal. They named the result the minimal access cranial suspension (MACS) lift and report 88 consecutive patients over 20 months.
Findings
- Performed under local anesthesia.
- Incision: inverted L-shape in front of the ear, extending below the sideburn; limited skin undermining.
- Two strong permanent purse-string sutures are woven into the SMAS in a vertical U and an oblique O shape.
- Both are anchored in the deep temporal fascia at the level of the helical crus (the upper front of the ear).
- Tying them gives a strong vertical correction acting mainly on the jowls and upper neck.
- An extended version adds dissection over the malar fat pad and a third vertical purse-string suture that acts on the nasolabial groove and lifts midface volume.
- 88 consecutive patients over 20 months; mean age 55.5 years.
- The authors report pleasing results and a very low complication rate.
What it means for a patient
- The MACS lift uses a shorter incision in front of the ear and lifts tissue vertically.
- It works mainly on the jowls and upper neck; an extended version also treats the cheek and nasolabial fold.
- It is done under local anesthesia.
- Results are the authors' own series of 88 patients over 20 months. The abstract gives no complication numbers or long-term data.
Why this paper matters
It described the MACS lift, a short-scar vertical facelift built on the S-lift, with a defined suture pattern and anchor point. It fits the trend the authors describe toward less extensive facial rejuvenation surgery. Cited 153 times (NIH iCite, 2026-09-25).
Terms
- MACS lift: minimal access cranial suspension lift, a short-scar facelift using purse-string sutures.
- S-lift: a short-scar facelift named for its S-shaped incision.
- Purse-string suture: a loop stitch that gathers tissue when pulled tight.
- SMAS: the layer of muscle and fibrous tissue under the facial skin and fat.
- Deep temporal fascia: a firm layer of tissue over the temple muscle, used as an anchor point.
- Preauricular incision: an incision in front of the ear.
- Undermining: separating skin from the tissue beneath it.
- Jowl: sagging tissue along the jawline.