My Philosophy on Facial Rejuvenation | What is minimal incision facial surgery? | What areas of my face are improved with a mini-incision endoscopic facelift?
Am I a candidate? | The Bottom Line

My preference for facial rejuvenation is mini-incisional to get a natural restoration with minimal scarring and downtime. Unfortunately, the term “mini-incision” is confusing because it has two meanings:
# 1: Endoscopic full facelifting of the upper, mid and lower face can be done through SMALL 1/2” to 1” INCISIONS PLACED INCONSPICUOUSLY IN THE SCALP. This is done using a tiny fiber optic lens attached to a camera and television monitor to allow visualization during surgical manipulation. Through these four or five incisions, tiny scissors, elevators, and sutures are passed and manipulated internally while the physician views the surgery on the TV monitor.
# 2: For older patients with more lower facial ptosis and neck fullness, MINI INCISION LOWER FACELIFT surgery is also used to describe SMALL S-like incision around the ear (1/2 the size of the traditional scar with nearly equivalent results.)
The endoscopic full facelift is great for the younger patient with early facial ptosis (drooping) where the removal of excess skin is not required. This is excellent for elevating, recontouring and smoothing out facial tissue.
For the 50-year old plus patient with a full neck, the upper and mid-facial ptosis can be corrected with the endoscopic technique but the lower third of the face and neck may need to be rejuvenated with a small mini-incision S-lift facelift procedure.
The results of the endoscopic facelift or mini-incision facelift surgery are optimized with laser skin resurfacing and/or fat transfer to help tighten and reinflate the face.
A review a photographs from your 20’s and 30’s helps Dr. Hughes determine the best choice with you.
First know that the face is divided into thirds.
This is lifted with an endoscopic browlift to elevate the forehead, the eyebrows, and the eyelids, and reduce the crow's feet and the frown lines. Because this raises drooping eyelids, in many cases this browlift postpones the need for an upper lid blepharoplasty or eyelid surgery.
Endoscopic mid-facelift: The mid-face begins where the lower lid and cheekbone meet and goes down to the nasolabial fold area. A mid-face elevation lifts the sagging skin and cheek fat and reduces the nasolabial fold and the jowls, and lifts up the corners of the mouth.
Contrary to what patients expect, the mid-face will not elevate with an incisional facelift and must be done with a superolateral vector endoscopically. Attempts to fix the aging changes in this area with traditional facelift gives the face a windswept look. The endoscopic mid-facelift is usually performed with an endoscopic browlift, on an outpatient basis with local anesthesia and IV sedation, and takes between 1.5 and 2 hours.
This can be improved in younger patients endoscopically with only small scalp incisions.
Endoscopic lower facelift: This is appropriate for patients with minimal neck banding and fullness and is done with an endoscopic upper and mid-facelift. It requires a more extensive facial dissection.
Over 55 years of age, a neck lift with or without a mini-incision facelift is often added.
Over the age of 40, the loose neck bands will be revealed, so usually a neck sling is recommended.
* Most incisional lower facelifts (S-lifts) have a necklift added to insure longer lasting results with a nice neck angle.
* It also can be performed in some women, but this is a more appropriate procedure for men with weak chins.
It can also be performed with a total endoscopic facelift if the patient has minimal jowling and neck ptosis.FOR THE BEST FACELIFT RESULT, THE ADDITION OF FACIAL FAT TRANSFERS, OR LASER SKIN RESURFACING CREATES A MORE NATURAL IMPROVEMENT.
Most patients get an endoscopic upper and mid-facelift before, during or after the lower facelift.