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.

The answer is that endoscopic midface lifts are still performed when the indications are suitable.  However, the goals and endpoints are more limited than a facelift.  Patients seeking facial rejuvenation with cervical obliquity and jowls will find that a facelift is a better choice of procedure.

Endo mid face lifts went away mostly since we have such nice fillers available and approved but the FDA that the results are not worth going through surgery.  There are still patients who are not filler candidates or who are looking for more results, so the surgery is still used when necessary.  

My personal reasons for not performing midface lifts any longer are many. Because I now perform deep plane facelifts that lift the midface, I see no reason to perform a midface lift as a separate procedure. Because fillers are so easy and effective, if someone is younger and doesn't need a facelift, but needs more midface volume, we just fill them. If they need a lot of volume we may perform fat grafting. If someone needs a facelift AND a lot of midface volume, I'll combine a deep plane facelift with fat grafting. A midface lift as a stand alone procedure is something I just don't do anymore.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa Aesthetic Centers

Mid face lift can be accomplished by multiple techniques. The key is finding the right procedure for the right patient. Sometimes nasolabial folds are best treated by a SMAS and lateral displacement of the skin to give a natural looking improvement to the face. A lift has to be done with the right vector of movement to realize the most natural outcome. See a board certified ASAPS plastic surgeon in consultation. Good luck...

Excellent question! Endoscopic Mid-Facelifts were designed to minimize incisions and speed recovery using very expensive equipment.  Screws inserted into bone were needed to maintain lift.  The procedure fell out of favor among most plastic surgeons because results were erratic and many times did not last.  Short scar Mini-Facelifts filled the void left because they too had the advantage of short scars and reduced recovery and swelling, and results are predictable and longer lasting.  Be sure to consult with a board certified plastic surgeon. Good luck!

Hello and thank you for your question.  Endoscopic facelifts do not generally produce long lasting results compared with a minifacelift with a SMAS lift.  If good technique is used, a mini facelift with SMAS lift can be done with minimal scarring and can result in a natural look, not
over-done look, with rejuvenation of your face.  Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results. The most important aspect
is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

HiThanks for your question. I did quite a few of these from 2005 until 2012The results are good. Especially initially. I found that the mid face elevation did not last as long as I would like. In part this is because the malar ligament in=s not full released as it in a deep plane faceliftsThat being said - if the mid face needs to be lifted in isolation....this is still my go to procedure.