Ask Dr. Pane: How many years does a MACS facelift last versus a SMAS facelift?

The Question

Facelifts are continually gaining in popularity among all genders and age demographics as people seek to reduce, stall or even reverse the effects of aging in the face and neck region, where age can show up more. However, facelift surgery has its share of myths, legends and erroneous beliefs attached to it, including the idea that it “wears off” over time. The topic of this week’s Ask Dr. Pane segment illustrates one of these myths. The viewer asks, “How many years does a MACS facelift last versus a SMAS facelift?”

The Answer

The first order of business, says Dr. Pane, is to dispel this idea that facelifts wear off. While a patient who has undergone a facelift will almost inevitably appear more youthful, this doesn’t mean the clock stops, gravity ceases pulling downward on the skin or that environmental and habitual factors don’t continue to exact a toll on the patient.

When a facelift is done properly, there is nearly always some surgical intervention in the superficial musculo-aponeurotic system, from which the SMAS facelift takes its name. This type of facelift is intended to rejuvenate and firm the skin of the face as well as the underlying structures. Dr. Pane notes as long as something is being done to the SMAS layer, the patient will get the benefit of a facelift to some degree. Some surgeons get fancier with how they do it, going deeper beneath the muscles and skin or using other, more invasive methods which Dr. Pane says he does not advocate for as a matter of preference, but regardless, intervention in the SMAS layer is uniformly the key reason why most patients with facelifts end up looking better.

The MACS facelift stands for minimal access cranial suspension. This procedure requires pulling up the skin and underlying musculature and locking it onto fixed structures in the face, such as the cheekbones and mandible, typically using sutures. It is less invasive than a full SMAS procedure, and in fact Dr. Pane notes many surgeons do a sort of combination procedure including facets of both SMAS and MACS.

In Dr. Pane’s opinion, the SMAS facelift gives better results which are more likely to be able to withstand the typical stresses and strains which lead to the face showing its age. In fact, he prefers the SMAS version to such a degree that it is his “go-to” methodology. This doesn’t mean he can’t or won’t use MACS anchoring as discussed above, if it is indicated or necessary for the patient to get the best results. However, he does not do so-called “thread lifts” or other smaller procedures which don’t deliver the same robust results as SMAS.

Done properly, neither SMAS nor MACS facelifts should “wear off” over time, which is what makes them the gold standard in combating the ravages of time, age, gravity and general life on the face. It is important to remember that prolonged or excessive exposure to environmental and habitual irritants such as pollution, cigarette smoke, alcohol and sunlight can modulate the results to a degree, and this will vary from patient to patient. Overall, however, Dr. Pane says a facelift is a very low-risk, low-pain procedure with a very smooth recovery curve and in his practice, a high degree of success with a very low rate of complications or postoperative issues.

It is important to remember that while Dr. Pane offers general advice on the pros and cons of various procedures, every patient, and every body, is unique. Because of this uniqueness and the outcomes each patient desires, an in-person clinical evaluation where the patient and surgeon can discuss the problem areas and come to a consensus on how best to address these areas is critical to a successful outcome. Some patients may not respond as well to a certain type of procedure, or need a less invasive form of surgery than others. While understanding the available options is certainly important and helpful, it is almost never a good idea to get married to the idea of one treatment option over another before a clinical consultation can be done.

RealSelf Patient Reviews of Thomas A. Pane, MD

If you have a question about anything regarding cosmetic surgery, the staff of Atlantic Coast Aesthetics are always happy to talk shop concerning your needs and goals. Simply email us through our site’s Contact page; follow us on Instagram, Twitter, Facebook and LinkedIn; or call us at (561) 422-4116. Your question may even be selected as the topic of a forthcoming Ask Dr. Pane segment, allowing us to educate and inform others who share your concerns and interests. Remember, at ACA, we believe the only bad question is the one you don’t ask!