Facelifting has evolved from its skin-only origins to now fundamentally include the SMAS in some way. The current ‘less-is-more’ attitude predominates, driven by patients’ demands for ever-shorter down-time. Although seductive in their apparent simplicity, the attendant strong vertical vector of such techniques as the minimal access cranial suspension (MACS) lift
1is not without its problems, which may include canthal crowding and sideburn elevation.
- Tonnard P.
- Verpaele A.
- Monstrey S.
- et al.
Minimal access cranial suspension lift: a modified S-lift.
Plast Reconstr Surg. 2002; 109: 2074-2086
2This has been conceded by the originators in their supplementary paper, which reported the need for pinch blepharoplasty of the lower lid to address the lateral orbital tissue excess in all of those in whom the 3rd, malar, suture was employed.
- Mendelson B.C.
Surgery of the superficial musculoaponeurotic system: principles of release, vectors, and fixation.
Plast Reconstr Surg. 2001; 107: 1545-1552
- Verpaele A.
- Tonnard P.
- Gaia S.
- Guerao F.P.
- Pirayesh A.
The third suture in MACS-lifting: making midface-lifting simple and safe.
J Plast Reconstr Aesthet Surg. 2007; 60: 1287-1295
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- Minimal access cranial suspension lift: a modified S-lift.Plast Reconstr Surg. 2002; 109: 2074-2086
- Surgery of the superficial musculoaponeurotic system: principles of release, vectors, and fixation.Plast Reconstr Surg. 2001; 107: 1545-1552
- The third suture in MACS-lifting: making midface-lifting simple and safe.J Plast Reconstr Aesthet Surg. 2007; 60: 1287-1295
- Is there a difference? A prospective study comparing lateral and standard SMAS facelifts with extended SMAS and composite rhytidectomies.Plast Reconstr Surg. 1996; 98: 1135-1143
- The zygorbicular dissection in composite rhytidectomy: An ideal midface plane.Plast Reconstr Surg. 1998; 102: 1646-1657
Published online: October 24, 2011
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.