My doctor says he will operate with a deep plane endoscope, is such a thing possible?

Question

I want a deep plane face lifting, A. Endoscopic forehead, brow and midface lifting B. Blepharoplasty C. Deep plane / SMAS lifting D. Lip Lifting.

Jacob Tower, MD · Answer

Hello, hope you are well. Great question! There are a couple contradictions in your plan, so there may have been something loss in translation. By definition, a deep plane facelift involves lifting the midface and obviates the need for an endoscopic midface lift. There are all sorts of modifications to the deep plane lift, but that is essentially the reason it was invented--to lift the midface in addition to the lower face. An endoscope is not traditionally used for a deep plane lift because there is a long incision for excess skin to be removed, and thus the view is not limited (and does not require a scope). 
Best,Dr. Tower

Stephen Prendiville, MD · Answer

An endoscope is appropriate for an endoscopic forehead lift and can be used for a subperiosteal midface lift. Both procedures are minimal incision techniques not dependent on skin removal.  I do not use an endoscope for a deep plane facelift because one of the goals after suspension of the deep plane flap is to remove skin.  Skin removal obviously requires an appropriate incision that allows this task to be accomplished.  An endoscope is really not necessary for a deep plane facelift alone.

Ercan Karacaoglu, MD, FEBOPRAS · Answer

Midface-lifting surgery is challenging owing to the difficulty of adequately releasing the soft tissues overlying the zygomaticomaxillary region and resuspending them effectively. A comparison of the extended transtemporal midface-lift and deep-plane face- lift  had been performed almost 13 years ago by a group of well known deep plane followers and they demonstrated that the there was statistically significant advantage of the transtemporal midface-lift on elevating the nasola- bial fold, particularly the melolabial suspension suture.

If you have prominent melolabial and nasolabial folds then this combination will most probably ensure the best satisfactory result.

This study is published in one of the peer viewed journals. Details can be seen there (Arch Facial Plast Surg. 2010;12(5):339-341)

Briefly, deep plane lifting can be fruitfully combined with mid face lifting.

Best wishes,

Ronald J. Edelson, MD · Answer

Endoscopic forehead lifts have pretty well been shown not to do much. I think the same can also be said about midface lifts. Personally I don’t care for the lip lift. If you look at pictures online you’ll see that a lip lift can drag down and distort your nostrils.  It sounds like you’ll be swinging a lot of extra money for things that I don’t think are worthwhile at all

Wayne F. Larrabee, MD · Answer

The endoscope is a good method to lift the midface and forehead. Both of these require repositioning tissue - brows and cheeks- but don't require skin excision. Although one can use and endoscope to help with the deep plane lift skin incisions and excision are still required to treat the jowls and neck well. If one is going to need to open the face and neck anyway not much advantage is gained by using and endoscope. So, in sum if you are only needing the midface and forehead endoscopic procedures are good but if you need a jowl neck lift you will usually need and open facelift procedure.

My doctor says he will operate with a deep plane endoscope, is such a thing possible?

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