Short Scar Lower Facelift that Won’t Leave You Looking “Overdone”

If concerns about facial scars, looking abnormal and apprehension about recovery time are inhibiting you from exploring surgical facial rejuvenation, the MACS lift (lower face/neck lift) procedure might be a good option for you. 

Developed in Europe about twenty years ago and popularized in the last ten, the MACS lift is a popular outpatient lower face and neck lift technique. Safe and effective, the procedure is kinder and gentler than traditional facelifts. It leaves significantly shorter scars, requires less downtime, and creates permanent resuspension of the deep soft tissues of the face and neck to a more youthful location. 

Dr. Horton Patient: Before and After Lower Facelift.

As we age, we naturally lose volume in our face that creates hollows, marionette lines and saggy of the neck.  While some volume can be easily corrected by injectable fillers, more permanent results can be found with the MACS lift (MA = minimal access, CS = cranial suspension). Together with select fat grafting, this surgery addresses the downward shifting of deep soft tissues of the face that contribute to an aged and tired look. With the MACS lift, we simply put sagging soft tissues back where they belong. The procedure typically takes less than four hours and patients go home later that day.

Dr. Horton in the operating Room.

Older facelift techniques pulled the cheek skin sideways, creating a too-tight, unnatural windblown appearance, and left long scars in the front of the hairline and behind the ear. The MACS lift is based on actual anatomy and the changes that occur with aging and time, such as descent of the soft tissues of the face and creation of jowls as tissue falls below the jawline.  

Dr. Horton Patient: Before and After Lower Facelift.

We offer this restorative surgical procedure to both women and men. The age range of typical patients ranges from the late 40’s to healthy 80-year-olds.  Patients are elated that the results are not obvious to others, but friends and family comment on how great they look.  Is it a new diet or hairstyle?  In photos, patients no longer gravitate to how old and saggy their neck looks.  Results are ‘subtle but significant’ and natural looking.  

‘Social downtime’ is around a month after surgery.  Work can continue from home after one week, and exercise can resume at around 4-6 weeks. My team teaches patients about scar therapy starting at 4-6 weeks, and final results are evident around three months.  

To see before and after results, visit my website gallery 

Top Photo Courtesy: TanyaLovus/

Karen M. Horton, MD, FACS

Dr. Karen Horton is an internationally Board Certified Plastic Surgeon in San Francisco, a fitness enthusiast, proud mom to fraternal twin girls, and devoted wife of nearly 3 decades. A surgeon’s daughter, she is proud to have built a successful, women-focused boutique private practice in Pacific Heights. Featuring a brand new Quad A-certified, fully equipped operating room, Dr. Horton offers her patients the highest level of aesthetic care, both surgical and non-surgical, in a modern, bright and discrete setting. She considers it an honor and a privilege to care for her patients! To learn more about Dr. Horton, visit and follow her on social at @drkarenhorton.