Endoscopic forehead and face-lift: Step by step

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The technique of endoscopy in facial rejuvenation is a new approach that has fascinated surgeons and patients for their ability to do face-lifting without removing skin. The combination endoforehead-endomidface lift is very appealing for the younger individual with sagging of the brows and midface. Typically, the operation starts with the midface dissection via lower blepharoplasty incisions. The endoforehead is performed using five slit incisions. A fascicular dissection of the supratrochlear nerve is mandatory to avoid damaging this nerve and to assure an accurate excision of the corrugator muscles. The midface subperiosteal-deep fascial pocket is connected with the temporal pocket through the splitting of the intermediate temporal fascia. Anchoring and suspension are done in a step-ladder fashion starting with the canthopexy, proceeding with the suborbicularis oculi fat suspension to the temporal fascia proper, and superficial temporal fascia to temporal fascia proper suspension. The frontal scalp is suspended to a percutaneous self-tapping screw post using skin staples. All the slit incisions are closed without removing skin except the lower blepharoplasty, that in most cases, skin muscle excision is required. The operation is finished with well-applied frontal and midface taping.

Key words

endoscopic forehead lift
endoscopic face-lift
facial rejuvenation
minimal incisions aesthetic surgery

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