The endoscopic facelift
- Principles
- This procedure targets a sagging forehead and eyebrows. It involves a few tiny incisions of about 1 centimeter each hidden in the scalp line of the patient. The grip of the muscles on the skin is attenuated and the tissue repositioned. In some cases, it is possible to effect treatment in the cheeks, cheekbones, and in the grooves running alongside the nose.
- In combination with other surgical procedures
- An endoscopic facelift can be the sole treatment or used in combination with other aesthetic techniques, such as the blepharoplasty (eyelid surgery), canthopexy (elevating the corners of the eyes), and a full surgical facelift (including the entire face and neck), as well as laser resurfacing, peeling, Botox injections, and so on.
- Indications:
- The Endoscopic Facelift rejuvenates the face by lifting the eyebrows. It also treats:
- drooping of the forehead due to horizontal wrinkles.
- drooping of the eyebrows with excess skin gathering in the upper eyelid area.
- worry lines between the brows.
- crow's feet in the corner of the eyes.
This surgical procedure, practiced on both men and women, is usually performed on patients 40 years or older, although it is sometimes done in younger patients due to hereditary factors that are not linked to the natural process of aging, such as low eyebrows or worry lines caused by muscular hyperactivity.
- Type of anesthesia and modalities of hospitalization:
- Two types of anesthesia are used:
- local anesthesia with light sedation.
- general anesthesia
The choice of anesthesia will be discussed among the surgeon, the patient and the anesthesiologist, and the best option chosen.
- Hospitalization
The endoscopic facelift can be done on an outpatient basis, with the patient released a few hours after the procedure. In some cases, a short hospitalization is preferable. The patient is admitted in the morning or the night before the procedure, and released the day after.
- Procedure
- The surgeon adapts his or her technique to each patient in order to obtain the best results. Certain features are held in common:
- cutaneous incisions: they are between 5 and 10 centimeters each, and three to five in all. They are placed in the scalp a few centimeters behind the hairline. One of them is designed for the passage of the endoscope linked to a video camera; the others allow for the insertion of various instruments designed for this endoscopic procedure. The scars from the incisions are almost invisible because they are tiny and hidden in the scalp.
- separation: The tissue of the forehead and the temple is separated. The area can sometimes extend below the base of the nose and the eye sockets to the cheeks and cheekbones.
- the muscles in this area are weakened in order to treat the wrinkles that they create, each muscle corresponding to a particular target area, such as the worry lines or crow's feet. Additional alterations in the musculature might be undertaken, depending on the patient's particular needs.
- repositioning: the separated tissue is resituated and pulled to remove the wrinkles, lift the brow and correct the drooping of the forehead. The tissue is held in place according to the method preferred by the surgeon.
- sutures: The small incisions are closed, often with staples that are easy to remove.
The procedure lasts 45 to 90 minutes, depending on the surgeon, the complexity of the corrections and the complementary treatment.
- Post-operative follow-up
- With an endoscopic facelift, there is little pain, but a degree of discomfort is possible, along with the sensation of a tightening in the forehead, temples and eyes. Rest is necessary the first few days, and patients should avoid strenuous activity. Swelling often occurs along with bruising for a period that varies from patient to patient. The bandages are removed between the first and third day, and the staples between the 5th and 15th day. The patient returns to work within 5 to 20 days, depending on the details of the procedure. Sometimes the brow is somewhat numb for the first few weeks, but numbness gradually disappears as healing occurs.
- Results
- Three to six months is necessary for the full effects to become apparent. This time is necessary for the fluids to be reabsorbed and for the tissue to become supple. Usually the procedure results in an appreciable rejuvenation of the upper part of the face, with a correction of the drooping brow, a lifting of the eyebrows, a tightening of the eyelids, a smoothing of the crow's feet, and a clear reduction in the lines in the brow. In general, the results are permanent. Although the aging process continues, the results are visible for years to come.
- Imperfect results
- Sometimes there is a discrepancy between the result one imagines and the results one obtains. It's possible that the wrinkles will be smoothed without being effaced, or that excess skin in the eyelid necessitates a complementary incision. Other unwanted effects stem from unexpected reactions within the tissues themselves, or a slight asymmetry in the eyebrows, or a reappearance of certain wrinkles in the forehead. These imperfections, if bothersome, can be corrected in a touch-up procedure that is usually conducted under a light anesthetic at least six months after the initial intervention.
- Possible complications
- An endoscopic facelift, though undertaken for aesthetic reasons, is still a surgical procedure, and entails the risks common to other surgical interventions. Sometimes the anesthetic causes side effects that are more or less difficult to control. For this reason, a top anesthesiologist, experienced in surgery, is necessary so that the risks are statistically negligible. That said, techniques in anesthesia have made enormous progress in the last 20 years and are perfectly safe for someone in good health.
- In terms of the surgery, it is absolutely necessary to choose a surgeon who is qualified, competent, and trained in the procedure. In this way, the risks are minimized though not completely negated.
- Fortunately, real complications are rare in an endoscopic facelift that follows the rules. In practice, the vast majority of endoscopic facelifts are without complication, and the patients extremely satisfied with the results.
- However, you should know that the following complications are possible:
- hematoma. Most of the time, hematoma are not serious, but can be drained if necessary.
- infection. This is rare when the procedure is conducted under normal antiseptic conditions.
- abnormal scarring, cutaneous necrosis, or hair loss are very rare. When they do occur, they are much less noticeable than in a classic facelift.
- lesions of the nerves. Sometimes lesions occur in certain sensitive nerves and result in numbness or irritation in the forehead and scalp. These symptoms diminish over time. Paralysis in the frontalis muscle is extremely rare and fortunately is usually temporary.
