7. In nearly all cases liposuction is performed to the neck area below the angle of the mandible, both to remove excess fat here and also to free up the skin to allow it to be re-draped by the suspension sutures.

8. In my opinion the MACS lift produces results at least equivalent, or in most cases, better than a conventional facelift. It is ideally suited to the younger patient with a sagging mid face. In patients with really excess skin facility in the neck region, it may be necessary in some cases to make an incision posterior to the ear to take up this slack, but in most cases this is not necessary.

DETAILS OF PROCEDURE

The operation is performed under a general anaesthetic and most patients stay in hospital for two days post operatively. The operation generally takes about three hours and in nearly all cases should be combined with lower lid blepharoplasty, as lifting up the malar fat pad also lifts up the lower eyelids and it is relatively simple to remove the excess skin. Usually no additional work needs to be done to the fat pads because of the suspension of the malar area.

During the post operative night, the patient is placed in a firm bulky woollen bandage and two small non-suction drains are inserted behind the ear. The bandage is removed the following day, along with the drains. Following this, a light chin-up bandage is worn for one week. Following this, the patient normally looks fairly reasonable, although there may be some residual bruising, particularly around the eyes. This is treated with Arnica cream and massage on a twice daily basis.

Stitches in the lower blepharoplasty incision are removed at three days, those in front of the ears and alternate stitches in the hairline are removed at five days and the remaining sutures in the hairline at ten days.