1. Perioral rhytids in pt with Fitzpatrick IV skin– options including HA filler, Laser,
dermabrasion list of : face lift no, liposuction no, dermabrasion ? yes, chemical peel ?
yes, laser no (no fillers/fat grafting as option)
2. Face lift options: Options include dermabrasion, laser, chemical, smas lift, macs,
a. 35 yr HIV pt with perioral rhytids (filler not an option) chemical peel as
smas/macs will do nothing for perioral rhytids, dermabrasion risk of HIV
transmission, laser will to nothing
b. 60 yr old with perioral rytids can do macs or smas
c. 40 yr old with early jowling smas lift or macs
3. Nerves potentially damaged by each of the three MACS lift sutures
What nerve does the anterior anchoring suture of a MACS lift come close to
Facelift = commonest nerve = greater auricular, commonest branch = buccal
MACS neck marginal mandibular commonest
Smas lift = buccal branch
1= neck marginal mandib
2= cheek buccal in 0 suture
3 = zygomatic branch facial in u suture