Deep plane vs endoscopic face lift?

Question

Hello so please with all due respect can a good doctor explain to me the differences between deep plane and endoscopic mid-face lift ? I will be very grateful towards the person who will give a true answer. So deep plane face lift is better for saggy cheeks or endoscopic face lift is better and why ? thank you. Take in consideration that the patient has saggy cheeks

Randal Haworth, MD, FACS · Answer

- In a deep plane face lift, the surgeon lifts and repositions both the skin and the underlying facial muscles, known as the SMAS (Superficial Musculoaponeurotic System). This technique allows for significant lifting of the mid-face area, including saggy cheeks, by addressing the deeper structures of the face. The results of a deep plane face lift can be long-lasting and provide natural-looking improvements.

- An endoscopic mid-face lift is a less invasive procedure that primarily targets the mid-face area, particularly the cheeks. This technique uses small incisions and an endoscope (a thin tube with a camera) to lift and reposition the tissues in the mid-face area. It is particularly effective for individuals with mild to moderate sagging in the cheeks.

**Which is better for saggy cheeks?**:
The most appropriate procedure for saggy cheeks depends on various factors, including the severity of sagging, the patient's anatomy, and the surgeon's expertise. In general, if a patient has significant sagging in the mid-face area, a deep plane face lift may be more suitable as it addresses both the skin and deeper tissues. However, if the sagging is less pronounced, an endoscopic mid-face lift could be a viable option.

I hope this helps,
best of luck !

Lucian Ion, FRCS · Answer

Thank you for your question. This is often a matter of some confusion in terms of understanding the impact on the midface between the deep plane facelift technique and the endoscopic midface lift.

In the original description, a midface lift does not involve lateral skin removal but can involve the removal of lower eyelid skin. The difference lies essentially in the depth at which the changes are made. The tissue that glides is usually further away from the surface of the bone, and in that sense, the changes of a deep plane facelift can sometimes be more powerful than what can be transmitted to the surface by an endoscopic technique operating on the surface of the bone.

More importantly, to help you make a decision about what is best for you, I suggest that you lie down completely flat and examine the appearance of your face in a mirror. You will notice a displacement of the volume from the lower part of the face along the jawline and increased volume around the midface. You will also notice a displacement in the lateral brow and corner of the eye. These changes correspond relatively well to what can be achieved with a deep plane facelift intervention.

The midface lift on its own is not likely to produce changes going as far down into the lower face. Unfortunately, the facelift also leaves longer scars than the midface lift, but once the facial tissue position is lifted, it tends to generate some skin excess. This is one of the limitations of the midface lift, as it does not cater to the change in characteristics of skin elasticity, as by design, it is not meant to tighten the skin.

Stephen Prendiville, MD · Answer

Simply put, the endoscopic midface lift belongs in the history book of ideas that were tried but didn't add a lot of benefit.  It's rarely an approach that will provide a great deal of benefit for the risk and recovery involved.
A deep plane facelift is a composite facelift, relying on release of ligamentous structures to allow for repositioning of the cheek, jawline, and neck.  In my opinion, it offers the best chance of consistent, natural results in facial rejuvenation. When performed correctly by an experienced Facelift Surgeon, all of the tension is placed on the SMAS layer, allowing for scars that are very hard to see.

James M. Economides, MD, FACS · Answer

Each of these terms describes different surgical techniques that target different problems.

An endoscopic surgery uses a surgical camera to assist the surgeon in visualizing and executing the surgery.  The reason an endoscope is used is to minimize the size of the incisions by having the surgical camera be the "eyes" for the surgeon through a tiny opening.  If this approach were limited to the "midface" the surgeon would only be addressing the facial aging of the cheeks or "midface."

A deep plane face lift is a term to describe an "open" (no camera - longer incisions) surgical approach that can address facial aging of the cheek (midface), jowls, neck, etc.

If you only show aging in the midface, an endoscopic mid-facelift may be the right option for you.  If you have aging in other areas of the face or neck, a full facelift or deep plane facelift may be a better option.

Lexie Wang, MD · Answer

The difference between the two is the approaches. Endoscopic means that you will be having the surgery done with the assistance of an endoscope, which is a surgical camera. Usually that means that you can get away with smaller incisions and perhaps less dissection, compared to a traditional "open" style surgery (meaning you are completely open up. Based on your question, it sounds like the endoscopic choice would only be for a midface lift, which distinguishes it from a traditional deep plane face lift that can address the midface, lower face, and neck.

Konstantin Vasyukevich, MD · Answer

Thank you for your question. The benefit of the endoscopic facelift lies primarily in its ability to lift the cheeks or mid-face. While it can also help elevate the eyebrows, it has a very limited effect on removing the jowls and neck sagging. On the other hand, a deep-plane facelift can accomplish cheek elevation similarly to the endoscopic facelift, but in addition, it is very effective at treating the jowls and lifting the sagging skin of the neck. Choosing the better option between these two types of facelifts would depend on your facial aging concerns, the degree of skin laxity, and the results you're looking to achieve. Please take a look at the following attached video to see if you would be a good candidate for a facelift. Best wishes, Dr. Konstantin

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