The third suture in MACS-lifting: making midface-lifting simple and safe

Area of Science:

• Plastic Surgery
• Facial Rejuvenation Techniques

Background:

• The Minimal Access Cranial Suspension (MACS)-lift is a short scar rhytidectomy utilizing vertical purse-string sutures for facial tissue suspension.
• It is performed in simple and extended versions, with the extended version incorporating a third malar suture for midface correction.

Purpose of the Study:

• To highlight the efficacy of the third malar suture in the extended MACS-lift for volumetric midface restoration.
• To demonstrate its advantages in softening the nasolabial fold and improving lower eyelid support.

Main Methods:

• The core technique involves using strong purse-string sutures in an antigravitational direction for neck and lower face rejuvenation.
• A simple MACS-lift uses two sutures for the neck and jowls/cheeks.
• The extended MACS-lift adds a third vertical malar suture for enhanced midface control.

Main Results:

• 557 MACS-lift procedures (183 simple, 374 extended) were reviewed.
• High patient satisfaction was reported, with a low complication rate (one major, 6% minor).
• The third suture effectively restored midface volume, supported the malar mound, and stabilized the lower eyelid.

Conclusions:

• The third suture in the extended MACS-lift provides natural midface lifting via a short scar.
• This technique effectively softens the nasolabial fold and offers robust lower eyelid support.