Endoscopy facelift or Spring thread lifting? (photo)

I am 34 old and I have sagging cheeks and also corners of my mouth are moved downwards. I have been lately doing some research regarding both Spring thread facelift and endoscopy facelift. Also came across modifications in endoscopic facelift. So far quite confused and don't know what would be right for me.

Doctor Answers 9


A subperiosteal midface lift with direct vertical elevation would help you considerably. Facelift technique results in a younger and natural, but not "done," look. The surgery is done in a deeper plane which results in a full-thickness skin and subcutaneous tissue flap, which is redraped and elevated vertically over a repositioned SMAS layer.

Boston Plastic Surgeon
3.7 out of 5 stars 23 reviews

Candidate for a facelift

If you feel that your face does not reflect how young you feel on the inside, a facelift may be the solution to help you look and feel younger. During your consultation, your doctor will evaluate your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure. Based on this evaluation, he/she will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. Your doctor should make sure you have a full understanding of what results to expect.Always insist on a board certified surgeon!

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews


In my opinion, none of the above - especially not thread/springs. The "risk/benefit ratio" is against you with any surgery at this time. If anything, well done fillers can accentuate the contour pleasantly.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.5 out of 5 stars 82 reviews

Endoscopy facelift or spring thread lifting?

Thank you for your question.At 34 years of age, you are still very young. I appreciate your concerns, and from your pictures, I can see your nasolabial folds.If you were my patient, I would recommend something as simple as fat grafting to your midface. That would certainly buy you a bit of time.Kind regards.

Ivo Gwanmesia, FRCS(Plast)
London Plastic Surgeon
4.7 out of 5 stars 32 reviews

Type of Facelift

Hello, although its difficult to answer your question specifically, i included a post about the anatomy and features of a facelift that may help you understand how things work and help you make your decision. 
James P. Bonaparte

James Bonaparte, MD, MSc, FRCSC
Ottawa Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Endoscopy facelift or Spring thread lifting? (photo)

You are beautiful. If you want to do something to your ace I wouldn't do any thing more aggressive than some  fillers which will help you.  Experience shows that when young women start doing  big things to their face early they wind up looking like very odd older women.  Thread lifts didn't work when they first came out and there is nothing to suggest that the physiology of the face has changed in the last decade. In my opinion they are tools for separating a needlessly insecure person from their  money.

Val Lambros, MD, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 8 reviews

Mid face lift

you have a beautiful face and I would certainly love to do just endoscopic midface lift to your face that will not only pick up your sagging cheeks but also will give you nice malar mound giving your face a more well defined and fresh look, rest I find you very beautiful unless you want a little upper lip pout because I would love to give you nice Cupid bow definition which will further enhance the whole look!

Monisha Kapoor, MBBS, MS, MCh
India Plastic Surgeon
4.6 out of 5 stars 9 reviews

Best face lift at 34

Thank you for asking about your face lift.
  • You have a gorgeous profile and in front view, slight loosening of the tissues.
  • It is impossible to make sense of various face lift claims without being trained in the field - so many claims are puffery and self-promotion.
  • Do not have a thread lift - a waste of time.
  • An endoscopic face lift has mixed results.
  • You should consider the following - filller along the cheeks and nasolabial lines to support the face (effects are temporary)  OR a small cheek implant AND/OR a short incision sub-SMAS face lift.
  • These will provide the support to your face to give you the lift you want.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Endoscopy facelift or Spring thread lifting?

 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts on women in their late twenties and early thirties that had early "jowl" formation.  From the photos your cheeks are flat anteriorly (in the front), there is slight excess fat in front of the cheeks (more on one side), jowls are present and the chin is weak.  These factors combine to create an elongated, rectangular shaped face.  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  I would combine liposuction to reduce the excess fat to further shape the cheeks.

 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 "Jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.  This can't be done using threads, suture lifts or an endoscopic face lift that do not allow for proper SMAS dissection/trim/elevation along with removal of excess skin.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.