Why aren’t endoscopic midface lifts done more?

The idea of an endoscopic midface lift is to elevate the upper cheek region and to do this via a short hidden scar or scars in the scalp region. It has not been a popular procedure unfortunately as results are a bit unpredictable. It suffers from a couple of problems. In order to lift an area, there needs to be a secure area above that to anchor sutures or tissue or skin. For a midface lift, there are options that are not always dependable and sometimes requires even placing a screw into the skull. Another problem with midface lift is that once the cheek is elevated, what does one do with the extra skin that bunches up after elevation. If there is a significant amount of skin, this would result in a fold. To remove the fold it may need to be surgically excised and this leaves a longer scar which the endoscopic facelift was hoping to avoid.

Thank you for an interesting question.  Endoscopic mid facelift is still successfully performed by some surgeons.  However, most doctors prefer other forms of midface rejuvenation.  Here are just a few problems associated with endoscopic subperiosteal midface lift: prolonged postoperative swelling, widening of the midface, inconsistent and unpredictable results, limited rejuvenating effect on other areas of the face.  When midface rejuvenation is necessary most surgeons today would turn to a deep plane (extended sub-smas) facelift, fat grafting and fillers to achieve most natural and long lasting result.

I was neve a fan of the endoscopic midface lift although I love the endoscopic forhed procedures. I prefer an open midface lift eben though it requires lower eyelid surgery as well. I like this better because I am better able to elevate and full reposition the tissues. Even more important however is how the tissues are kept in their new position. More direct suturing is able to be done using the open method.