The lifting of gravitationally relaxed cheek could make Asian patients to be dissatisfied with the surgical results due to the protrusion of zygoma. When the MACS-lift was applied as the facial lifting technique to counter the effects of aging in the mid-facial area of Asian patients, the third purse-string suture that lifts the malar fat pad was applied on most of the patients with normally-shaped zygoma. The simple MACS lift and extensive MACS lift were conducted for 3 patients and 18 patients each, respectively. The survey after 6 months from the surgery showed “satisfied” in 15 patients, “very satisfied” in 3 patients and “no difference” in 3 patients. The other two plastic surgeons evaluated the results after 6 months from the surgery. In the experience of the authors, the third purse-string suture of the MACS lift was effective in the elevation of the malar fat pad. Considering the Asian facial characteristics of wide and protruded zygoma, the fullness of the zygomatic area has been an issue for concern, however, patients who wanted to have a younger-looking face are now satisfied with this appearance due to changes in aesthetic standards in recent years.