Facelift from short access. MACS, SMAS and Spacelift - ways to rejuvenate the face

S-lifting is a surgical technique for correcting age-related changes in the middle and lower thirds of the face and neck and general visual rejuvenation. The name of the method comes from Short Scar (short scar), so another term that is often used to define this method is short scar lifting.

What it is

The technique is one of the three basic surgical techniques (lift using minimal access), so S-lifting is often referred to by the same term - MACS-lift.

Peculiarities

Short-scar facelift combines the advantages of a length-limited incision (i.e., minimal tissue dissection) with the advantages of the method (PMAS) - lifting a deep layer flap consisting of facial muscle fibers and connective tissue. Correction according to the S-lifting system allows you to achieve the best cosmetic results by lifting not only the skin, but also the tissue structures under the fiber. Moreover, the rejuvenating effect is achieved without the effect of the "mask".

The aesthetic result of short-scar facelift is maintained for a long time (up to 8-10 years) due to the vertical fixation of the tightened "flaps" of deep tissues, and is comparable to the effect of SMAS-lifting. The operation, after agreement with the surgeon and if indicated, can be repeated.

Kinds

In addition to the S-lift, which is one of the three versions of the MACS-lift, there are J and V-lifts. The letters S, V or J indicate the type of incisions being made. The name S-lifting is due to the shape of the characteristic incision, similar to the Latin letter S.

Indications

It is believed that S-lifting is best performed on relatively young skin in patients from 35 to 50 years old with moderate facial and neck skin defects, with a preserved facial contour line and in the absence of very noticeable signs of sagging tissues.

But experts insist that the S-technique has a noticeable effect on more mature skin, if a certain degree of elasticity is maintained.

deformation of the contour of the lower jaw;
weakening of the muscles around the mouth and drooping of the corners of the lips;
flabbiness of the skin in the cheek-zygomatic region;
omission of the outer corners of the eyes - pulling the eyelid to the temples makes the look open and young.

In the case of deep loose folds, it is advisable to combine the S-lifting technique with and.
To achieve complete rejuvenation in patients over 50 years old, it is recommended to combine the S-procedure with lifting the forehead and.
With deep contour deformations, severe skin folding, nasolabial wrinkles, it is advisable to perform an SMAS lift or combine S-lifting with the Frac 3 3D technique.

Contraindications

Among the contraindications, there are a number of diseases and some conditions of the epidermis, in which the procedure is prohibited:

diabetes mellitus in the stage of insulin dependence;
diseases of internal organs in the active stage;
autoimmune pathologies, oncological processes;
dysfunction of the heart and blood vessels in severe form;
, pustular skin diseases in the treatment area;
low blood clotting;
insufficiency of the kidneys, liver;
allergic reactions$
long-term nicotine use (up to 20 cigarettes a day)

Comparison with other similar techniques

First of all, surgical intervention in S-plasty involves tightening not only the skin and subcutaneous tissue, as, for example, with rhytidectomy, but also the deep muscle-tissue layers. This provides a pronounced effect of S-lift with minimal tissue excision.

The main difference between the technique of a short-scar facelift and the standard facelift procedure is an incision limited by a zone in front of the auricle with vertical fixation of sagging facial tissues in the temporal zone. This avoids excessive skin tension and distortion of natural facial expressions when correcting age-related defects.

Advantages:

The method is aimed not only at superficial skin tightening, but also at lifting the subcutaneous structures of the face (SMAS). The aesthetic result of rejuvenation is achieved while maintaining a lively facial expression.
Low invasiveness of the operation, exclusion of damage to the facial nerve and subsequent paresis due to non-standard tissue excision;
The minimum area of the exfoliated skin area, which reduces the likelihood of postoperative complications.
Limited incision length, which allows you to hide the fact of surgical intervention;
Carrying out a micro-incision within the pre-ear zone, without moving to the temple area. This eliminates focal hair loss along the growth line in the back of the head and its displacement upwards and backwards (which often happens after a classic surgical lifting).
Reduced surgery time, use of light short-term anesthesia using intravenous injection.
Fast recovery after the procedure due to low blood loss and low trauma.

How is the S-lift performed?

Preparatory stage

Preparation for the Short Scar facelift includes:

consultation of a surgeon, related specialists for possible contraindications;
necessary laboratory blood tests.

If the patient plans to get rid of excess fat mass, the process of losing weight should be completed before the start of the operation, so that during the surgical procedure, excess sagging skin folds, often formed after rapid weight loss, can be removed.

10-14 days before the procedure, you need to give up alcohol and nicotine, which increases the likelihood of complications and delays the healing process of the dermis at the treatment site.

Operation progress

The surgical procedure lasts from 2 to 4 hours, depending on the volume and complexity of the operation.

Subsequence:

Combined anesthesia is performed - local anesthesia and intravenous injection
Microcuts are made according to the chosen scheme. Usually, with S-lifting in women, retrotragus incisions are made to maximize the masking of the subsequent scar. In male patients, the tissue is dissected in the area of the natural fold of the anterior region.
The tightened skin and SMAS flap - a fragment of the deep muscle-fat layer (PMAS) are fixed with suspension sutures to the periosteum of the zygomatic zone at a higher point. The tissues of the lower third of the face are lifted, the angle of the lower jaw is highlighted, the contour is leveled and sagging “flews” are eliminated. To straighten the nasolabial folds, tighten the skin on the neck, additional stitches are applied.
The excess skin flap is excised and the wounds are sutured with intradermal cosmetic sutures using a hypoallergenic non-absorbable thread.
The thread is removed from the suture after tissue healing - usually 8-12 days after surgery.

The first improvements become noticeable after 10 to 20 days, after bruises, swelling and seals have resolved. A full-fledged cosmetological effect will be increasingly evident over 2 to 5 months.

Recovery period

After the S-lift, patients go home for 1 or 2 days. Bruises disappear by 5-7 days. To make them less noticeable, dry cold (a cold heating pad wrapped in sterile gauze) should be applied to the places around the incisions for 2-3 days. Soreness is relieved by taking Analgin, Pentalgin, Ibuprofen. Swelling on the face subsides within 10-12 days.

Until the sutures are removed, the patient must wear a pressure bandage necessary to support the tissues in the bucco-zygomatic and submental region. If short-scar lifting was performed, combining it with liposuction of the chin, the bandage is continued to be worn before a night's sleep for another 3-4 weeks.

To speed up the healing process and prevent possible complications, for a month you should follow some rules:

do not expose the skin in the face and neck area to heat,
give up hot baths, saunas, baths;
avoid sun exposure of the skin in the treatment area;
to exclude solariums, bathing in open reservoirs and the pool;
prevent physical overwork, exclude weight lifting, sports loads;
during sleep and rest, use a high pillow and, if possible, lie on your back;
until the seams are completely healed, exclude makeup and caring cosmetics;
treat the face and neck only with the means recommended by the beautician.

As for the physiotherapy shown after lifting, they are prescribed only by a doctor, based on an analysis of the condition of the skin and surgical sutures. Microcurrents, ozone therapy, special massage, carboxytherapy, procedures with the use of regenerating and regenerating masks, magnetotherapy have a wonderful effect.

Short-scar facelift MACS-lift and S-lift

The average cost of the operation is 52 "500 rubles.

The MACS-lifting technique (Minimal Access Cranial Suspension Lift) was invented and first applied by Colombian plastic surgeon Patrick Tonnarde more than 10 years ago. The S-Lift (Short-Scar Lift) is one of the modifications of the MACS-lift, which received this name because of the cut in the shape of the letter S.

These facial plastic surgeries are designed to lift the middle zone of the face and the lower third through small incisions in the ear area. The specificity of a short-scar facelift lies in an inconspicuous small scar, a shortened rehabilitation period and high efficiency. The size of the incisions is much smaller than with a classic facelift.

MACS-Lift and S-Lifting. Indications

loss of clear contours of the oval of the face;
manifestation of moderately pronounced or deep nasolabial folds;
drooping corners of the mouth;
moderate decrease in neck skin turgor;
deterioration of facial skin turgor, gravitational ptosis of tissues in the cheek area.

MACS-Lift and S-Lifting. Contraindications

blood clotting disorder;
collagen vascular diseases;
exacerbation of inflammatory processes in the body;
predisposition of skin tissues to the formation of keloid scars;
smoking as a factor that increases the risk of postoperative complications (should be stopped at least 2 weeks before surgery);
taking anticoagulants (it is also necessary to stop at least 2 weeks before the operation);
oncological diseases.

MACS-Lift and S-Lifting. How is the operation carried out?

The MAX lifting operation is performed under general anesthesia. The surgeon starts the incision from the lower lower edge of the lobe, continues it in front of the ear (behind the tragus) and slightly captures the temporal region along the border of hair growth. Then the doctor performs a sparing limited detachment of the skin flap. Effective tissue lifting is carried out by applying purse-string suspension sutures to the superficial musculoaponeurotic system (SMAS). These sutures are securely fixed to a strong structure - the deep temporal fascia. A vertical vector of tissue lifting is provided. Thus, the doctor tightens the deep structures of the buccal region, thereby improving the contours of the facial contours. The surgeon then tightens and redistributes the skin flap, removes the excess, and applies a cosmetic suture.

With the S-Lift (Short-Scar Lift), excess skin is removed using an S-shaped incision, which, unlike the MAX-lift, starts behind the ear and ends in front of the auricles, and the lifting method is similar to the MACS-lift. Of all existing braces, S-Lift (along with MACS-Lift) is the most gentle for the patient. More than half of the operations are performed under local anesthesia. The duration of operations is 1.5 - 2 hours.

MACS-Lift and S-Lifting. Rehabilitation

The patient is discharged 1-2 days after the operation. After the operation, for a week and a half, it is necessary to wear a compression bandage, which provides pressure on the chin area and cheek-zygomatic area. On average, the main hemorrhages and edema disappear within 12-14 days. The stitches are removed on days 9-11. The final effect can be observed 6 weeks after surgery.

MACS-Lift and S-Lifting. Photos before and after

Currently, this type of operation is included in the daily practice of most foreign specialists and some surgeons in Russia. You can see the results before and after a short scar lift in the portfolio of a plastic surgeon on his website. Additionally, you can visit the section "Photo before and after" on our portal.

MACS-Lift and S-Lifting. Prices

The cost of the operation is in a wide range from 50,000 to 140,000 thousand rubles. The average price of this type of lifting in Moscow is 110,000 rubles.

Where to do short-scar facelift MACS-Lift and S-Lifting?

Choose a certified specialist. In order not to make a mistake with the choice, study the rating of the best plastic surgeons in Russia. In addition, you can seek advice on the forums of Internet sites specializing in aesthetic plastic surgery.

With the advent of numerous sparing procedures aimed at skin rejuvenation, minimally invasive intervention has become the most in demand in aesthetic medicine. The classic circular facelift has been replaced by the use of contour plastics, threads, hardware cosmetology procedures and low-traumatic surgical intervention.

S-lifting is a modern skin rejuvenation technique, the name of which comes from the English phrase “Short Scar”, which means “short scar” in translation. Despite the low invasiveness of the surgical intervention, the S-lift includes elements of the SMAS-lift, designed for a complete reconstruction of the face oval by fixing the musculoaponeurotic system.

Characteristics and features of the S-lift

Short-scar facelift is a surgical rejuvenation technique aimed at lifting the internal structures of the face and excising excess skin. The main feature of the operation is minimal trauma and small scars located behind the ear tragus. Thus, a small seam remains invisible to others. At the same time, S-lift is not a procedure aimed only at lifting the upper layer of the skin. The operation affects the deep structures of the face, due to which global rejuvenation and improvement in appearance are achieved without the effect of a stretched mask.

The incision is made in the parotid area and can be extended to the temporal region. The technique of short-scar lifting allows you to achieve a tightening and rejuvenation of the lower third of the face and neck, eliminate age-related wrinkles, nasolabial folds and ptosis in the lower part of the face. The effect lasts for a long time due to reliable stable fixation of deep soft tissues.

Advantages and disadvantages of the operation

The main advantages of S-lifting include the following factors:

The fundamental limitation of the incision, which allows you to hide the fact of the operation;
Strictly vertical fixation of lowered facial tissues. Unlike the classic facelift, in which the tissues are fixed up and back, this technique avoids the effect of skin tension, and also preserves the duration of the result achieved;
No risk of damage to the facial nerve due to non-standard tissue excision;
Small invasiveness of the operation. The intervention lasts for a short time period, sparing local anesthesia is used with the use of mild intravenous sedation;
SMAS lift. Lifting is aimed at tightening and fixing the muscular-aponeurotic system, which provides natural permanent rejuvenation;
Low incidence of complications;
Relatively low cost;
Accelerated recovery. Small blood loss significantly reduces the time for the patient's rehabilitation after surgery. Strict restriction of the incision reduces the risk of patchy hair loss, which often occurs after standard surgical lifting.

Disadvantages of a short scar facelift:

S-lifting is not always effective for deep loose wrinkles in the lower third of the face and neck. Patients with such a problem are recommended to combine the operation with other procedures of hardware and therapeutic cosmetology;
After surgery, patients experience pain of medium and low intensity when chewing. The pain is localized in the cheekbones, where the fixing subcutaneous sutures are located.

Indications for surgery

Mild to moderate ptosis of the lower third of the face and neck;
The formation of age brylya;
Pronounced deepening of the nasolabial folds;
Excess lipid tissue in the chin area;
Omission of the contour of soft tissues and skin in the area of the lower jaw;
Flabbiness of the neck;
Cheek tissue ptosis, partial deformation of adipose tissue;
Weakening of the muscles of the mouth.

Short-scar facelift is an alternative to the classic circular facelift for those who want to correct age-related gravitational changes in the lower part of the face. If the patient has particularly deep loose folds in the area of the mouth and neck, it is better to combine the S-lift procedure with contour plastic surgery. A positive result is achieved in almost all cases, except for patients with pronounced excess sagging skin in the neck area. The most acceptable age for a short-scar facelift is between 38 and 50 years of age. To achieve complex rejuvenation, it is recommended to combine a face lift with a forehead lift and circular blepharoplasty.

Contraindications

Among the absolute contraindications, there are a number of diseases and some aspects of the patient's lifestyle. Relative contraindications include aesthetic factors.

The operation is contraindicated in the following cases:

insulin-dependent diabetes mellitus;
Chronic diseases of internal organs in the acute stage;
Severe skin diseases;
autoimmune disorders;
Diseases and dysfunctions of the cardiovascular system;
Long history of smoking;
Tendency to form keloid scars.

Surgeons do not recommend surgery for people with excessive accumulation of skin in the lower third of the face and chin area. Also, S-lifting is not recommended for people whose age-related changes in the face are concentrated in the temporal and frontal zones.

How is the operation carried out?

Stage 1. Preparing the patient for surgery, premedication is possible, depending on the chosen anesthesia.

Stage 2. The introduction of combined anesthesia. In the classic version, local anesthesia and intravenous sedation are used for such an intervention.

Stage 3. The surgeon performs the main incisions (in the posterior tragus zone in women and the anterior one in men).

Stage 4. Fixation of soft tissues in a new position and the imposition of suspension sutures into the periosteal tissue of the zygomatic zone.

Stage 5 The imposition of additional internal seams.

Stage 6 Gentle excision of excess skin flap after SMAS lift, intradermal sutures.

Removal of subcutaneous sutures is performed by the surgeon on the 7-10th day after the surgical intervention.

Recovery period after S-lift

Stationary observation in the clinic is observed for 1-2 days from the moment of the manipulation. The patient is required to apply a compression bandage, which should fix the zygomatic and chin area constantly until the sutures are removed. After that, a compression bandage may be recommended by the doctor at night if the operation was preceded by liposuction of the cheeks and chin. Bruises and swelling disappear in 5-7 days. Often they do not occur at all. During the rehabilitation period, it is recommended to switch to liquid and grated food due to painful sensations when chewing. After a week, the discomfort usually disappears.

To speed up the healing process, some surgeons recommend turning to physiotherapy and manual procedures. An excellent effect is shown by special, microcurrents, magnetotherapy, caring procedures using healing masks.

Saving the result and possible complications

The risk of complications associated with the S-lift procedure is minimal. Most often, it is associated with improper implementation of the doctor's recommendations, as well as the choice of an unqualified specialist. In these cases, blood loss and prolonged healing are possible (if the patient uses anticoagulants, antibiotics and active smoking), infection in the area of skin flap resection, persistent hematomas and edema due to neglect of wearing a compression bandage.

The effect of the operation remains for a long time and is comparable with the results of a complex one. Thus, a noticeable rejuvenation of the skin is achieved, and the result is maintained for 10 years or more. The technique can be repeated, if there are indications for this, after agreement with the plastic surgeon.

s-lifting plus blepharoplasty

According to experts, rejuvenation requires certain sacrifices, so not all plastic surgeons share the opinion that youth is necessarily minimally invasive manipulation. On the contrary, only a comprehensive radical intervention will achieve results. However, one recent invention, the S-lift, has already proven itself to be an effective and relatively non-traumatic intervention. It is a limited intervention combined with lifting and lifting of the skin and subcutaneous structures.

Currently, people seeking surgical facial rejuvenation want to get the maximum effect with a minimum of risks and disadvantages. As a result of rejuvenating plastic surgery, they would like to see a natural appearance combined with a minimum of complications and a short recovery period.

Indications

The presence of sagging skin areas in the lower half of the face and on the neck;
Skin laxity;
Violation of the correct outlines of the face;
Deformation of adipose tissue under the skin;
Excessive content of adipose tissue in the chin and buccal area;
Violation of the tissues of the facial muscles;
Strong age-related changes.

Contraindications

smoking abuse;
The presence of chronic diseases;
irreversible dermatological diseases;
Diseases of the cardiovascular system;
Weakening of the immune system;
Violation of blood clotting;
Tendency to form keloid scars.

Surgical intervention in this case is carried out in stages:

Preparation of the patient for surgical manipulations and the introduction of anesthesia;
Anesthesia of the patient. Basically, a combination of local anesthesia and sedation (intravenously) is used for S-lifting;
The doctor makes the incisions necessary for work (behind the tragus or in front of the ear);
Fixation of soft tissues in the required position, the imposition of special lifting sutures in the cheekbones on the periosteal tissues;
Overlay of internal seams (in addition);
Excision of excess skin after tissue lifting, intradermal sutures.

IMPORTANT: Subcutaneous sutures are removed by a specialist about a week after the completion of the operation.

Advantages

Soft tissue excision ensures that there is no possibility of damage to the facial nerve;
Limited incisions, due to which the fact of the intervention is not obvious;
Only vertical fixation of ptosis of facial tissues. For comparison: with a facelift, the tissues are fixed backwards and upwards, which makes the skin appear stretched;
Minimally invasive manipulation. The intervention does not take much time and the methods of anesthesia used do not involve a long recovery;
Noticeable skin tightening effect. Natural rejuvenation is achieved by lifting muscle and skin tissue;
Minimal risk and number of possible complications;
Availability at cost;
Short recovery period and minimal blood loss, no risk of hair loss (as happens after a surgical facelift).

Flaws

Painful sensations when performing chewing movements (sometimes the patient feels severe pain) in the area of \u200b\u200bthe location of the sutures for fixation (cheekbones);
Insufficient effectiveness in the presence of skin friability and depth of wrinkles on the neck and in the lower facial half. In this case, a combination of S-lifting with hardware and other procedures is required.

rehabilitation period

After S-lifting, the patient stays in a hospital for about 2 days, if there are no problems, he is allowed to go home the next day. At this time, it is necessary to wear a compression bandage to create and maintain guiding pressure on the chin and cheek-zygomatic area.

After 10 days, the bandage will only need to be worn during sleep (for about a week, sometimes longer), especially if liposuction of the chin area was performed. After the operation, hematomas sometimes appear, which pass on their own after 5-7 days.

IMPORTANT: The first time after the procedure, it is necessary to refuse solid food, otherwise severe pain is possible. After a week, the pain disappears if there are no complications.

Magnetotherapy;
Lymphatic drainage massage;
Masks for skin recovery;
Microcurrent therapy;
Ozone therapy.

Result and possible complications

The skin after the operation noticeably rejuvenates, the effect lasts for a decade, sometimes longer. The results are especially noticeable after tissue healing.

The risk of complications after the procedure is minimized, it is high only when an inexperienced doctor without a sufficient level of qualification takes over, or if the patient does not follow the recommendations of the surgeon. In this case, the wound will take longer to heal, and severe blood loss may occur during manipulations (especially if the patient takes antibiotics and smokes), infection of the wound surface, persistent hematomas and swelling.

It is possible to repeat such a procedure in agreement with specialists.

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(S-lift, Short-Scar Lift) - a modification of the SMAS-lift, performed through a small S-shaped incision in front of the auricle. A short-scar facelift combines low trauma and a short rehabilitation period with the advantages of SMAS-lifting - the ability to perform a facelift of the superficial musculoaponeurotic system of the face and lateral platysmaplasty. A facelift with a short scar is ineffective for severe skin laxity, requiring the removal of excess neck skin. Candidates for a short-scar facelift are patients between the ages of 30 and 45.

Candidates for a short-scar facelift are patients between the ages of 30 and 45 who wish to have some skin tightening with minimal scarring and no significant changes in the neck area. With the help of S-lifting, it is possible to eliminate cheek jowls, a double chin, drooping of the cheekbones and cheeks, sharp nasolabial folds, slight flabbiness of the skin of the neck. Also, a short scar facelift may be recommended for patients who require repeated facelift procedures.

With the S-lift, natural aesthetics are improved and facial rejuvenation is achieved with minimal skin incisions and a rehabilitation period. At the same time, a short-scar facelift is a full-fledged multifaceted operation that combines skin tightening and subcutaneous SMAS-structures of the face. For complex facial rejuvenation with a short-scar lift, blepharoplasty of the lower and upper eyelids is ideally combined.

Advantages

A short-scar facelift does not require a behind-the-ear incision as with a traditional facelift. Due to this, the operation is characterized by low traumatism, which is especially preferable for smoking patients. In rare cases, a facelift with a short scar requires an additional incision in the temple area, which will be securely hidden in the hair. The absence of an incision in the posterior region prevents the possibility of damage to the branches of the facial nerve.

Due to the vertical tissue tightening performed during the S-lift, it is possible to achieve the most natural effect of rejuvenation. The imposition of special sutures that support the internal structures of the face allows you to adjust the angle of the lower jaw, eliminate jowls and tighten the skin of the neck. During a facelift with a short scar, the subcutaneous SMAS structures of the face are lifted, which determines the long-term results of face and neck rejuvenation.

A short-scar facelift is associated with shorter surgery and anesthesia time, traumatism and blood loss, which reduces the rehabilitation time. The limited incision provides a smaller wound surface, and the absence of stitches behind the ears reduces the risk of hair loss, which is very high after a classic facelift.