MACS Facelift by Dr. Durkin

MACS FaceLift

For those who do not like injectables, and those that need a quick lift without less than a week of downtime, look no further than the MACS lift. MACS is an acronym that stands for “Minimal Access Cranial Suspension”, or MACS. In this procedure, a different type of incision is used than a limited incision lift. Here, the incision is carried further into the hairline, as lateral brow elevation is one of the outcomes of this technique.

MACS lifts are strong, durable, and in the right patient, they offer world class results. We believe this specific technique is best utilized in men and women who have minimal neck descent, but lateral and lower face descent. These lifts do involve relocation of the SMAS layer, or deep skin layer. In this procedure, elevation is produced by a plication technique at specific locations in the fixed and mobile SMAS planes. As such, MACS lifts can provide durable rejuvenation for years in patients who are best suited for this approach.

Who is best suited for MACS lifts?

Patients who present with cheek, jowl, or lower face descent are best suited for MACS lifts. However, the bulk of the MACS effect is at the jawline and above. As such, we do not prefer this technique in patients who place a premium on neck rejuvenation. In patients whose neck is a concern, we recommend either a Limited Incision Ocean Drive Facelift®, or full Facelift procedure.

Read MACS Lift Diagram
MACS Lift Diagram illustrated by William Winn, Atlanta, Georgia.

Before

See before photo of patient
Before MACS Facelift.

After

See after patient photo after MACS facelift
After MACS facelift by Dr. Alan Durkin.

Before

Facelift Before
Facelift Before

After

Facelift After
Facelift After

Post Op Instructions:

Daily Care

1. Go over your suture lines 2-3 times daily with soap and water on a Q-tip around the front and the back of your ears. Apply a small amount of Bacitracin Ointment to the suture lines around the front and back of the ear.

2. The second day after surgery let warm water run over incisions while showering. If you had eyelid surgery do not be afraid to get sutures around the eyes wet when showering.

3. Report any excessive bleeding that persists after pressure for 20 minutes.

4. Report any signs of infection such as excessive swelling, redness, or drainage.

5. Under no circumstances should ASPIRIN, IBUPROFEN, or medications containing aspirin or salicylates or ibuprofen, be taken without first consulting us.

 

Removal Of Dressing

A facial dressing will be applied before you leave
the operating room; it is to remain in place until
the following morning. You should be as quiet as possible during this time; therefore, a great deal of talking and having too many visitors are discouraged. If your dressing begins to feel excessively tight or uncomfortable, please let us know. The dressing can be removed the following day after surgery unless told differently by either Dr. Durkin or the nurse. During your initial post-op appointment you will be placed in a bandeau to be worn 21 days.

 

Pain

There is usually little actual pain following a facial reconstruction, but you may experience a deep bruised sensation as a result of the swelling, and
the face may seem heavy, this can seem worse at
night and when one becomes nervous. You will receive a prescribed pain medication and it can often cause sensations of light-headedness or sleepiness, particularly in the immediate post-operative period.
If you choose to not take prescribed pain medication you may take Tylenol. Under no circumstances should ASPIRIN, IBUPROFEN, or medications containing aspirin or salicylates or ibuprofen, be taken without first consulting us. If the pain is severe and the prescribed pain medication is not helping please do not increase the recommended dosage or supplement with your own medications. Notify our office and we will evaluate the next step in controlling your pain.

 

Swelling

Every operation, no matter how minor, is accompanied by swelling of the surrounding tissues. The amount varies from minimal to extensive. Sometimes the swelling becomes a little greater 48 hours after your operation and will gradually decrease. Swelling is generally worse when you first get up in the morning. The swelling itself is not serious and is not an indication that something is going wrong with your operation.

It may take several weeks for the swelling to diminish completely. After the swelling diminishes though, you may notice or feel some unevenness (lumpiness) under the skin; this will gradually disappear.

The main thing to remember is the swelling eventually subsides; you can help in several ways:

  1. STAY UP (sitting, standing, walking around) asmuch as possible on your first post-operative day.IMPORTANT, you should rest when you are tired.
  2. AVOID BENDING OVER OR LIFTING heavythings for one week. Besides aggravating swelling, this may raise the blood pressure and you could start bleeding.
  3. AVOID HITTING OR BUMPING YOUR FACE, HEAD AND NECK. It is wise not to pick up small children and you should sleep alone for one week after your operation.
  4. SLEEP WITH THE HEAD OF THE BED ELEVATED for 1-2 weeks after your operation. To accomplish this, place two or three pillows under the head of the mattress and one or two on top of it. Try not to roll on your face; this tends to tear down the supporting stitches used under the skin of your face; therefore, it is necessary to sleep on your back for 2 weeks. Some patients find a reclining chair placed at a 45 degree angle to be more comfortable.
  5. Under no circumstances should ASPIRIN, IBUPROFEN, or medications containing aspirin or salicylates or ibuprofen, be taken without first consulting us.

 

Ice Compresses

Soft washcloths or the ice packs that we provide to
you can be used. Some patients have even used bags of frozen peas due to the fact that they will conform to the face. If you decide to use a soft cloth, dip in water with ice chips. They may be placed in a plastic wrapper such as a baggie to avoid wetting your clothing. Apply your preferred method across the jaws and neck for twenty minutes several times daily during the first 3 days may help reduce swelling, discomfort, and discoloration.

 

Discoloration

Discoloration and bruising are normal with a facial reconstruction. Like the swelling, it may become more pronounced especially in the neck and chest area after the first day or so, but remember this is temporary. You may apply Topical Arnica Cream to discolored areas avoiding incision sites.

 

Medication Instructions

Every post-op patient will recieve the following four meds which may be adjusted due to medication allergies etc.

  • Antibiotic to start the following day after surgery.
  • Muscle relaxer typically this is Diazepan. Take onetablet every 12 hours as needed. Please take this one hour apart from your pain medication. This can be sedative do not drive while taking.
  • Pain medication to be taken with food you may start once you get home after surgery. We advise you to take a stool softner as your pain medication may cause constipation. You may alternatively take Tylenol if you chose. DO NOT take IBUPROFEN or ASPRIN.
  • You are given a packet of Ondansetron for nausea. this is to take only as needed. Once every 8 hours. If symptoms do not resolve contact office.

 

Care Of Surgical Site

You may shower once you’re cleared by Dr. Durkin. When Dr. Durkin gives the ok you may shampoo your hair and gently cleanse the incisions with soap and water. Avoid “scrubbing” the incision sites. Use
a gentle massage with your fingertips around the incisions. Have someone with you and a chair nearby the first couple of days that you shower. You may get a little dizzy and will need to sit down. Gently towel dry hair and allow to air dry. Do not use a hair dryer or curling iron until after the staples and sutures are removed. Your scalp could have some numbness for up to a few months after surgery so it is important that you use extreme caution when using a blow dryer or curling iron until the numbness is gone. Keep incision site clean using dial soap and applying bacitracin to incision site.

An antibiotic has been given to you. This is begun
the day after surgery and continued until gone. Avoid extreme turning of the head as this may place undue tension on the healing suture lines, but on the other hand, do not hold head rigid as this will result in stiffness of your neck. Under no circumstances should ASPIRIN, IBUPROFEN, or medications containing aspirin or salicylates or ibuprofen, be taken without first consulting us.

 

Diet

The night of your surgery you may feel nauseated. We have provided you with anti-nausea medication. You can take the medication and only take a few ounces
of clear fluids until the nausea passes. There are no restrictions to what you can and can’t eat. Let your body determine what you feel like eating. Please no drinking of alcohol for the first 3 weeks and/or while taking the pain medication and the anti-anxiety medication. Alcohol may raise the blood pressure and initiate bleeding.

 

Depression

It is not unusual for an individual to go through a period of mild depression after cosmetic surgery because, no matter how much they wanted the operation beforehand and how much they were
told about what to expect post-operatively, they
are shocked when they see their face swollen and, perhaps, discolored. Be realistic and realize that this is a very temporary condition which will subside shortly. The best “treatment” consists of busying one’s self with the details of post-operative care and trying to divert one’s attention to other thoughts. Do not compare your progress with that of other patient’s, everyone heals differently.

 

Activity

Limit your activity over the first week following your surgery. We encourage walking, but AVOIDING bending over at the waist, or picking up heavy objects, or straining in any way. If you overexert yourself, bleeding may result. You may slowly resume your activities after the first week, but please avoid any strenuous activity until Dr. Durkin gives you the OK…this is usually around 3 weeks after surgery.

If the activity involves being outside please use the appropriate protection from the sun (sunscreen, hat, etc.), even a mild sunburn may cause prolonged swelling and/or irritation of the incisions and skin.

Returning to Work and resuming Social Activities

When you should return to work depends on the amount of physical activity and public contact your
job involves and also the amount of swelling and discoloration you develop; the average patient may return to work or go out socially 2-3 weeks after surgery when these factors are minimal- you will have to play this by ear! Do not drive for 2 weeks and/or if you’re taking the pain medication.

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