The Pros and Cons of Endoscopic Facelift Surgery

endoscopic surgery

Only a few small incisions are required during an endoscopic facelift to rejuvenate the upper two thirds of the face.

Thinking of getting a facelift? If so, there’s certainly no shortage of options to choose from, ranging from mini facelifts to traditional surgical facelifts and everything in between.

One particularly interesting procedure, however, if you’re looking for a relatively inexpensive and convenient alternative to a conventional facelift, is the endoscopic facelift — sometimes referred to as an endoscopic vertical facelift or endoscopic mini facelift because it concentrates on the mid-portion of the face, rather than the neck and jowls.

A minimally invasive procedure, endoscopic facelifts are a popular choice for those who are unhappy with the appearance of the skin around their forehead, eyes and cheeks, with the ideal candidates being those with moderate imperfections caused by fatty tissue and loose facial muscles.

In other words, it’s not generally recommended for people with more pronounced signs of aging, but most commonly performed on people in their 30s, 40s and 50s with only moderate amounts of sagging skin. So if the objective of your facelift is to create a tighter neck area, there are better options available for you.

What is an Endoscopic Facelift?

The Endoscopic Facelift is a relatively new procedure, so named because doctors implement an endoscope (a pencil-shaped camera probe which allows them to see inside the facial structure) in order to minimize the amount of incisions that will be necessary.

This tool requires only a few small incisions — often smaller than an inch long each — that are easily hidden once the surgery is completed. It also affords surgeons more accuracy than with standard facelifts, despite the smaller incisions.

The procedure goes like this: your doctor will make a series of small incisions in the scalp, just above the hairline, in the mouth, under the eyelids and above the ears. Using the endoscope and a monitor which displays the images, he or she will separate the facial structures — including the skin, fat and muscle — from the bone and lift them in order to create a smoother, tighter appearance.

Your doctor then removes excess fatty tissue and reshapes the muscles and tissue into a more desirable shape, effectively eliminating the majority of the issues which cause facial skin to droop or sag with age. Those championing the procedure claim you can expect to enjoy the full results of an endoscopic facelift for up to 10 years following surgery.

So how does an endoscopic facelift differ from other types of facelifts? Well, as stated earlier, the primary difference is that conventional facelift options tend to focus on the cheek, jowls, jaw line and neck, whereas the endoscopic facelift concentrates on the upper two thirds of the face. However, doctors are also finding new ways to use the procedure to correct issues with the lower face as well.

For example, Los Angeles-based Dr. Chia Chi Kao first started to implement the endoscopic technique into the lower area of the face in 2015, essentially performing what’s now known as an endoscopic lower facelift, or endoscopic jowl lift. And with his PonyTail Endoscopic Facelift, Dr. Kao uses an endoscope to minimize the jowls with less prominent scarring. It’s likely more of these whole-face endoscopic methods will become increasingly common over the next few years.

Results and Recovery

The risks and recovery associated with the traditional facelift are exacerbated due to the extended nature of lifting the cheeks and neck, whereas the smaller incisions in the endoscopic procedure generally promise less complicated recovery and risk. Not only do these incisions require less time to heal, they also lower the risks associated with infection and cause less pain and swelling during recovery.

With that being said, most patients who undergo an endoscopic mid-facelift will experience mild bruising and swelling for a period up to 12 days, along with some minor itching as the incisions heal. After approximately one week, the sutures are removed to allow for complete healing.

Most patients are able to resume their normal activities within two weeks of their surgery.

The Pros of Endoscopic “Scarless” Facelift Surgery

As with any cosmetic surgery, there are benefits and drawbacks to the endoscopic facelift. However, there are significantly more pros than cons associated with this procedure — less downtime, easier recovery, smaller incision sites — that make it a uniquely promising option for a wide range of patients.

  • Less Scarring — The endoscopic facelift is sometimes referred to as “the scarless facelift,” because it requires smaller, less conspicuous incisions than a traditional facelift. Those who are concerned about long-term scarring will want to consider this procedure over other options. In some cases, endoscopic facelift scars will be visible, but doctors are able to make the incisions in more inconspicuous spots so they remain better hidden.
  • Quicker Recovery — Again, due to the less involved incisions with the endoscopic approach, you’re likely to experience a faster recovery than you would with other kinds of facelifts. The endoscopic facelift recovery time is shorter and less intensive than a traditional facelift, with patients experiencing the full effect of the procedure in roughly three to six months. Typically, endoscopic facelifts are performed as an outpatient surgery, another factor contributing to their requiring significantly less recovery time than other methods.
  • A Lower Risk-Factor — Since the endoscopic facelift requires smaller incisions, the chance of infection is lower than it would be with a conventional facelift. Nevertheless, patients may still experience the same side effects and risks generally associated with mask-style facelifts, such as swelling and bleeding. Most patients also experience mild soreness and numbness, but report it subsides in a few weeks’ time. As with any surgical procedure, there is also the potential risk of nerve injury, excessive bleeding and/or experiencing adverse reactions to anesthesia.
  • More Accurate Facelift Results — The endoscope allows doctors to peer deep within the facial structure, enabling them to make very precise and effective moves without going too deep. If you have a highly specific vision in mind, you should talk to your doctor about this method. Because your doctor is able to see more with this procedure, you’re more likely to get an accurate result with an endoscopic facelift than you would with a procedure that doesn’t use an endoscope.

The Cons of Endoscopic Facelift Surgery

  • Not Ideal for Lifting the Neck or Jowl — This type of facelift is generally only recommended for patients who want a lift in the forehead, eyes and cheeks. Because the neck and jowls are not affected during this procedure, it’s primarily recommended for those who are pleased with the look of the bottom of their face but want to address loose, sagging skin in the top portion.
  • Price — In general, the cost of an endoscopic mid facelift is fairly expensive, but the final price will depend on how much work is required and where you choose to have the procedure performed. With that being said, this type of facelift can run you anywhere from $6,000 to $10,000, which is actually on-par with most other “mini-facelift” options but significantly more affordable than a complete facelift (aka the Deep Plane Facelift).
  • Risk of Injury — Although not exclusive to this type of facelift, there are some risks associated with injury to the eye area. This is a primary concern with endoscopic forehead lifts, or those facelifts primarily performed to tighten the area around the eyes and forehead. However, such complications are quite rare.
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