We know the traditional facelift as a procedure that repositions the skin on the lower face and neck for a younger-looking appearance, and while it’s still as popular as ever, there’s another technique called the endoscopic facelift that Los Angeles plastic surgeon Peter Lee, MD has been performing a lot, too. This technique involves the use of an endoscope to see what the eyes cannot, so it requires smaller cuts and therefore minimal scarring. Below, Dr. Lee answers our burning questions about this technique and everything it entails.
Is an endoscopic facelift dangerous?
“An endoscopically assisted facelift is not more or less dangerous than traditional techniques. In the hands of an experienced and skilled surgeon, facelift procedures are safe and effective. The major concern with all techniques is that the surgeon is working in close proximity to the facial nerves, which animate the muscles of facial expression. Endoscopic dissection has an advantage here in that it provides a very clear and magnified view of the dissection plane.”
What are other advantages of an endoscopic facelift?
“The magnified picture provided by the endoscope allows the surgeon clear visualization of the tissues and anatomic structures, particularly at the distal aspect (further away from the surgeon) aspect of the dissection. This also helps us target many areas of the face, including the jowls, the cheeks, the nasolabial folds, and sagging skin in the neck area.”
How do you prepare the patient for an endoscopic facelift?
“First, the patient’s face and neck are carefully evaluated from a variety of different angles. Next, I assess the laxity and redundancy of the skin and soft tissues at many different locations of the face. The location of the temporal hairline and sideburn are then evaluated to determine the ideal placement of the surgical incisions. The facial skeleton is also evaluated to determine whether its modification would enhance the overall result of the endoscopic facelift. Finally, an assessment is made of whether the aesthetic result of the facelift could be improved by performing concomitant adjunctive rejuvenating procedures.”
What is the age range of patients coming in for an endoscopic facelift?
“The typical facelift patient is in their mid-50s and beyond, but a middle-aged patient with signs of aging in the middle and lower third of the face is a solid candidate. I tend to find that many younger patients are seeking procedures with smaller incisions, but minimal incision techniques are often associated with minimal results. By using endoscopic assistance, these younger patients can achieve more comprehensive results through the smaller incisions that they prefer.”
Is it more popular than a regular facelift?
“Endoscopic facelift techniques require specialized equipment and a specialized skillset. Therefore, it is more difficult to find a surgeon skilled in these techniques.”
What is the downtime?
“Because endoscopic techniques involve more targeted dissection, recovery time can be enhanced, as it ensures that bleeding, bruising and swelling are minimized. Although full recovery can take several weeks, most patients are presentable in public in one to two weeks and can return to work within that timeframe.
A few know-before-you go post-operative steps: The patient’s face and neck are loosely wrapped in kerlex and acewrap dressings after the surgery. These will be changed on the first postoperative visit the first day after surgery. If any drains have been placed, these are usually removed on the second day after surgery. The patient’s face will feel fight and look swollen in the first few days post-operation. By the time all the staples and sutures have been removed, the patient will be able to appreciate the early results of their surgery.”
How many endoscopic facelifts do you perform every week?
“We typically perform two to three endoscopically assisted facelifts in a given week.”