I often times get asked what type of facelift technique do I prefer to do on my patients. The answer to this is – it depends on the type of facial anatomy that I am presented with and the desired change. Essentially any facelift procedure done today involves some type of lifting of the SMAS layer (also known as the superficial musculo-aponeurotic sytem). This is the thicker fibrous layer of tissue that sits below the skin and above the muscles of the face. In order to effectively lift the face and get a long-term esthetic improvement, one has to involve the SMAS layer in one or another. The main differences between the various facelift techniques mostly relate to if and how far below your surgeon dissects the SMAS to lift the face. Some facial plastic surgeons go quite deep, therefore, the term deep plane facelift. Others go a short distance under the SMAS and some don’t even lift the SMAS at all. Instead, they tighten the SMAS layer with permanent sutures to get a similar result. The MACS facelift technique has gained increasing popularity recently and is a variation of the SMAS suture tightening technique. The MACS lift (which stands for minimal access cranial suspension) involves placing a series of suture loops anchored to the deep fibrous tissue above the ear. By strategically placing these suture loops, the surgeon can effectively lift the lower face and upper neck to achieve a nice cosmetic improvement. All of these facelift techniques have been used by surgeons to achieve great cosmetic outcomes over the years. In many cases, patients aren’t even aware of what technique was used in their particular case. Not that it really matters as long as your surgeon is comfortable with their chosen technique and has enjoyed safe, successful outcomes over time. Dr. Hilinski.