Subperiosteal Endotine-assisted vertical upper midface lift.
- Johannes Franz Hönig
- Aesthetic surgery journal
After a delay of several years, endoscopic surgery was introduced into cosmetic surgery of the face in 1992. Initially, its indications were very limited as they only concerned resection of corrugator muscles for the treatment of wrinkles between the eyebrows. Today, it has a new lease of life, with the ambition of replacing classical forehead facelift, by constituting a surgical approach. It replaces the bicoronal incision by means of 5 small incisions which allow detachment and resection of the depressor supercilii muscles similar to that obtained via a bicoronal incision. The skin or scalp excess is absorbed by various techniques. However, endoscopy now has other ambitions: functional fronto-orbital surgery. It tries to achieve a new muscular equilibrium by resection of the depressor supercilii muscles and release of the levators: occipitofrontal muscle. In this way, this new technique achieves an entirely natural repositioning of the eyebrow. The authors describe all of the technical possibilities by endoscopy, median frontal endoscopy, endoscopic frontal facelift, endoscopic extraperiosteal masklift and endoscopic subperiosteal masklift, in the case of the forehead. A special technique has been developed: temporomalar facelift. Lastly, although cervicofacial dissection is technically possible using videoendoscopy, there nevertheless remains a major stumbling block: the excess skin. Based on an experience of more than a hundred cases over a period of more than 18 months, this technique provides extremely encouraging results leading the authors to adopt this technique definitively.