To restore the maturing face to its natural youthful appearance, plastic surgeons perform various procedures specific to each area. The endoscopic mid-face lift and endoscopic forehead lift address the early signs of aging that emerge in the upper and middle regions of the face. The rhytidectomy (facelift) addresses the later signs of aging that emerge in the neck and lower region of the face. These procedures can be performed individually or in conjunction with one another, depending on your facial rejuvenation needs.

Endoscopic Mid-face Lift

Is your smile still worth a thousand words?

The earliest signs of aging affect the mid-face region. The cheekbones start to lose their structure, cheek fat starts to droop, and smile lines begin to emerge. You're growing weary of seeing yourself in the mirror looking tired and sad when you're not. It may be time to give up your skin-firming creams--but it's not time to give up!

In the mid-face the most noticeable changes occur under the eyes and around the cheeks. The deepening of the nasolabial creases (i.e., smile lines or cheek folds) and the increasing lower eyelid depression lend a saggy appearance to the face. The endoscopic mid-face lift (i.e., vertical lift, mini lift, or cheek lift) elevates sagging skin and cheek fat, thus reducing smile lines and relieving lower eyelid depression.

The endoscopic method has several advantages over the traditional, or open, face lift because it is less traumatic to the body. Although patients with minimal to moderate skin excess are best suited for the endoscopic forehead and mid-face lift, the procedure may also be performed in conjunction with a rhytidectomy (facelift).

Preparation

Eat a balanced, nutrient-rich diet before surgery. A healthy diet will help speed recovery. Also plan ahead and prepare nutritious meals that are easy to warm up so that you won't need to spend too much time in the kitchen during your recovery.

If you smoke, abstain from smoking for at least six weeks before and after surgery. This reduces the risk of infection and encourages faster healing.

Do not take any medicines containing aspirin or ibuprofen during the two weeks preceding surgery.

Do not eat or drink after midnight the night before surgery.

Be certain you do not have a cold or sunburn the day of surgery.

Do not wear make-up or contact lenses to surgery.

Arrange to have someone take you home after surgery and, if possible, help you around the house for a few days while you recover.

MidFacelift Surgery

The procedure generally takes one to two hours and is usually performed with local anesthesia and sedation. Hair is tied back and trimmed behind the hairline where the incision will be made.

Your surgeon will make three to five short incisions (each less than 1 inch in length) inside of the mouth and along the hairline. An endoscope (a tiny camera) is inserted into one of the incisions allowing your surgeon to view the muscles and tissue beneath the skin.

The fat pads of the cheeks are vertically repositioned over the cheekbones.

The incisions are closed with stitches, and bandages are applied.

What to Expect

After the procedure is over, patients may experience some numbness and mild swelling and/or discomfort at the incision site. This is normal and will pass with time. Incision site pain is usually minimal and can be controlled with medication, if necessary. Swelling can be treated with cold compresses. Endoscopic mid-face lift patients experience less itching than patients who have undergone a traditional face lift.

Within two days you should be up and about, although you should continue take it easy. Also, once the bandages have been removed (usually within the first two days) you'll be able to shower and shampoo.

Within a week, stitches or staples can be removed, and within two weeks fixation screws can be removed. Within three weeks most of the visible signs of surgery should be gone. Although patients will probably feel ready to return to work or school within seven to ten days following the procedure, they should take it easy and limit rigorous activity for several weeks.

Prolonged heat and sun exposure should be limited for several months. Most of the visible signs of surgery should fade completely within about three weeks. Minor swelling and bruising can be concealed with special camouflage make-up.

Risks

As with any surgery, there is the risk of complication. Most complications associated with endoscopy are minor and will pass with time. Possible complications include nerve damage (usually temporary), infection, bleeding, and reactions to the anesthesia. You can reduce your risk of complications by closely following instructions both before and after surgery.

If a complication should occur during an endoscopic forehead lift, your surgeon may have to abandon the endoscopic approach and switch to the conventional, open procedure, which will result in a more extensive scar and a longer recovery period. To date, such complications are rare -- estimated at less than 1 percent of all endoscopy procedures.