There is significant appeal in minimizing the scars of more traditional techniques of facelifts while providing a means to create a more natural and youthful looking face. With the growing popularity of injectables and Botox™, fewer traditional facelift procedures are being performed today. Minimal access cranial suspension (MACS) facelift is emerging as a popular technique for the management of the aging face. The MACS facelift provides a less “wind-swept” appearance due to its more vertically-oriented vectors that provide the suspension. However, despite a less extensive dissection and a shorter incision, the MACS lift is not without its complications.

We report our series of 15 MACS lifts in the past 15 months and retrieved their demographic data and indications for this procedure. We reviewed our modifications of this technique and our complications, and we compared them with more traditional methods of facial rejuvenation. With some postoperative findings relating to neuropraxia, failure of the suspension, and asymmetry, this procedure is not without its complications. Finally, a telephone survey was performed to determine the patients' satisfaction with the procedure.

Despite these minor complications, we report that there is a steep learning curve with respect to this procedure. Ultimately, we believe that the MACS lift is long-lasting procedure and will eventually become one of the more favored procedures in the surgical treatment of the aging face.