Comparison of Deep SMAS Lift and MACS in Facelift: A Meta-Analysis

<i>Background and Objectives</i>: According to the PRISMA guidelines, this meta-analysis evaluates the outcomes of deep Superficial Musculoaponeurotic System (SMAS) lift versus Minimal Access Cranial Suspension (MACS) lift techniques in facelift surgery. <i>Materials and Methods</i>: We reviewed literature that included 20 studies involving a total of 7716 patients, of which four studies met our inclusion criteria, focusing on 286 patients (MACS n: 186 and SMAS n: 100). Our analysis assessed surgical duration, complications, pain levels, and aesthetic results. <i>Results</i>: Although both techniques yielded comparable aesthetic outcomes and postoperative complications, the MACS lift demonstrated a significantly shorter surgical duration (SMD = 2.05; 95% CI [1.61-2.48]; <i>p</i> < 0.00001, I² = 0%) which has high impact on patient recovery, risk of complications and cost-effectiveness. <i>Conclusions</i>: The findings underscore the need for further research into varying techniques to solidify their efficacy and safety profiles.