Endoscopic subperiosteal browlift and facelift.

The subperiosteal facelift is an excellent technique for remodeling particularly the central third of the face. The endoscope has allowed us to perform rejuvenation of the upper face or the total face without incisional scars. On the other hand, the introduction of the endoscopic techniques to the biplanar surgery allowed us to perform the deep dissection with more safety and accuracy and to eliminate or decrease some of the undesirable sequelae of the traditional approaches such as the numbness on the forehead beyond the hairline or scalp incisions. In the lower face, the endoscopic techniques allowed us to protect the marginal mandibular branch of the facial nerve, and, on the neck, these techniques allowed us to perform a very accurate subplatysma dissection. The endoscope has allowed us to create a new technique for facial rejuvenation that can be equal to and perhaps in some cases even more versatile than other traditional, nonendoscopic approaches. In this way, we can tailor the operative procedure to the patient's needs rather than to give one type of operation to every patient that walks in for an office consultation. It will become imperative to outline the indications, contraindications, and limitations of each variation and to determine the appropriate role of the endoscope in facial rejuvenation. Only then will we better serve our colleagues and our patients.