See Dermal Fillers, above.
forehead lift ($2,500 to $7,ooo)
Endoscopic Face-Lift or brow Lift
An endoscope is a small surgical instrument that can be inserted under the skin through small incisions, allowing a surgeon to perform a cosmetic corrective procedure via microsurgery. The endoscope itself is a miniature camera with a light fitted on one end of a long tube. When inserted under the skin the camera transmits magnified images to a television monitor.
During the procedure the surgeon watches the screen as the endoscope functions as the doctor’s under-skin eye. Simultaneously, the surgeon inserts and uses other small surgical instruments, including scalpels, scissors, or forceps to actually perform the operation. These are used to remove excess fatty tissue and to reshape facial muscles and tissue that have become loose over time. In this way, many of the key factors contributing to sagging or drooping in the face are resolved.
Endoscopic face-lifts are an optimal way to minimally impact the skin and yet achieve impressive results for some types of wrinkles and sagging, and can have results similar to a traditional face-lift but without cutting and pasting sections of skin.
It turns out that a good deal of the skin’s tendency to sag over time is a result of the face’s muscles and fat pads shifting down and in toward the center of the face. This is what happens with the deepest furrowed lines on the face, particularly on the forehead and with the nasal labial folds from the nose to the mouth.
Let’s say your jawline is beginning to sag. Using the somewhat simple surgical procedure called endoplasty, the surgeon makes a mere quarter-inch-long cut underneath the chin and at each edge of the jaw, and then, via microsurgery (the surgeon watches what is being done via a television screen), sutures the platysma muscle, which extends from jawline to jawline under the chin, back where it belongs.
For reasons similar to those causing skin to sag, the deep frown lines and vertical creases in the mid-forehead result from a literal slippage of the forehead muscles downward and inward, as well as just simple frowning and movement of the forehead. The same endoscopic technique used to anchor the platysma muscle can be used on the forehead muscles, and an additional separating of the muscles between the eyebrows can reduce the fold lines there. This operation can be done via three tiny incisions inside the hairline, allowing the surgeon to anchor the slipped muscles back in place and to cut away a small section of the muscles between the eyebrows.
There is a great deal of research showing that endoscopic face-lifts can achieve impressive results. However, because it is a very difficult surgery and requires a physician be skilled in microsurgery, it is not a popular method, although it has minimal to none of the risks associated with traditional surgical procedures.
(Sources: Archives of Facial and Plastic Surgery, January 2009, pages 34-39; Facial and Plastic Surgery, February 2007, pages 27-42; Plastic and Reconstructive Surgery, January 2002, pages 329-340; Facial Plastic Surgery Clinics North America, August 2001, pages 439-451; and Aesthetic Plastic Surgery, January 2001, pages 35-39.)