The fourth suture in MACS facelifting – adressing the neck

Abstract

Objective: The MACS facelift alone shows poor results on the medial neck in cases of pronounced, rigid platysmabands (McKinney III–IV°). The original MACS (“Minimal Access Cranial Suspension”) facelift delirs excellent results on the midface and leads to sustainably improved outcome on the neck by adding a fourth suture on the platysma. McKinney type I–II platysmabands can be treated only by lateral approach of the ‘fourth suture’, type III–IV should be treated with closed platysma myotomy before.Methods: Between October 2007 and November 2013 a number of 219 patients were treated with the MACS facelift technique accomplished by a fourth suture on the platysma and liposuction or optional lipectomy on the neck. On 47 patients closed transcutaneous platysma myotomy was performed.Results: Surgery time lasted on average 2.5 hours and was performed under sedation with local anesthesia in 85%. Recovery time ranged between 14 to 16 days until the patients were back to work. Due to their health status 54% of our patients had an inpatient arrangement for one night and 46% an outpatient arrangement.Conclusion: The modification of the MACS lift with the ‘fourth suture’ on the platysma keeps the benefits of the original technique but improves the aesthetic outcome on the neck.

Keywords

• MACS lift
• face lift
• neck lift
• fourth suture
• platysma myotomy