Use of Ancillary Procedures in Combination with the MACS-Lift for Facial Rejuvenation: A Retrospective Cohort Study.

Background: While facelifts remain central to facial rejuvenation, ancillary procedures are essential for addressing aspects of aging not corrected by facelifting alone, such as soft tissue atrophy and skin quality. Despite their routine use, few reviews describe their role alongside facelifts in modern practice.

Objective: To define the range of ancillary procedures used with the Minimal Access Cranial Suspension (MACS) lift in current practice.

Methods: A retrospective review was conducted on all MACS-lift procedures performed by the senior authors from January 1, 2018, to December 31, 2024. Data collected included demographics, surgical and ancillary procedures, and complications.

Results: The MACS-lift technique has evolved to include deep neck reduction, centrofacial lipofilling, and skin resurfacing. Among 380 patients (356 females, 24 males), 81.8% underwent a primary facelift. Ancillary procedures were performed in 98.9% of cases, with an average of 5.8 procedures per patient, with this average being higher for female than for male patients (6.0 vs 4.5), and higher for patients 55 years or older than for younger patients (6.17 vs 5.13). The most common ancillary procedures were lipofilling (96.3%), brow lift (72.6%) neck lift (67.9%), nanofat microneedling (64.7%), blepharoplasty (57.4%), and lip lift (27.6%). Mean operative time was 3.93 hours. No major complications occurred. Minor complications included neuropraxia (4.7%), infection (2.9%), skin necrosis (2.9%), sialoma (2.6%), seroma (2.4%), hematoma (1,6%) and wound healing disturbances (1,3%).

Conclusions: Ancillary procedures are frequently and safely combined with the MACS-lift to address facial ptosis, volume loss, and skin aging, enhancing overall rejuvenation outcomes.

Level Of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .