In step with Dr. Talei, who does now not carry out endoscopic facelifts however is famend for his deep aircraft experience, older endoscopic tactics that tunneled all the way down to bone led to lots of swelling and produced effects that lasted, on most of the people, a couple of yr and a part. However the extra novel and “technically difficult” endoscopic deep aircraft facelifts can also be “a actually just right choice for choose sufferers who don’t want a large elevate,” he says. “They’re now not simply advertising and marketing.”
As this process’s approval ranking grows so too does proof supporting its efficacy. In 2023, Dr. Kao and Dr. Mani printed separate peer-reviewed articles detailing their respective endoscopic approaches. Dr. Kao is hopeful that his paper, examining 600 consecutive ponytail circumstances over 22 years, will sway “naysayers who say it does not paintings or is just for younger folks.”
Dr. Kao gives 4 distinct “ponytail” operations, each and every designed to take on an expanding level of laxity. Whilst his youngest (and tautest) sufferers depart the OR with simply 4 tiny slits hidden of their hair, the ones of their mid-40s, 50s, and 60s will have further incisions at the back of (or, hardly, in entrance of) the ears to take out redundant pores and skin from the face and neck.
With the least invasive of his procedures, Dr. Kao can tighten “all of the method all the way down to the attitude of the jaw via incisions within the temple space,” a maneuver that “got here to me perhaps six years in the past,” he says. For a very long time, he couldn’t see how one can do it safely with out injuring a significant facial nerve. Ultimately, inspiration struck because it so frequently does: “I figured it out within the bathe.”
Dr. Mani’s endoscopic method mimics his standard deep aircraft manner, save for the incisions, which he conceals within the hair of the temples and at the back of the ears (sparing the scar in entrance of the ears). Not like Dr. Kao, who plays ponytail procedures solely, Dr. Mani operates endoscopically in 60% to 70% of sufferers. He’ll in a different way carry out a standard deep aircraft facelift with conventional incisions.
Each docs say the longevity in their endoscopic lifts competitors that of same old deep aircraft procedures and that complication charges and restoration sessions are just about equivalent. When talking of protection, Dr. Mani tells me that the endoscope in fact offers him an edge by way of making “the nerves seem like large snakes,” so he can steer clear of them extra simply.
Then again, navigating an endoscope—a talent now not each surgeon possesses—can lengthen an already long process. Dr. Kao’s most complicated facelifts can take 10 to 12 hours, two times the time of a typical deep aircraft facelift. Some view this as a possible problem, in particular for older sufferers who in the long run finish up wanting incisions in entrance of the ears anyway, the very factor they’re aiming to steer clear of with an endoscopic elevate. If there’s a chance that the ones incisions shall be important to take away extra pores and skin, says Dr. Nayak, the affected person is also at an advantage with a standard deep aircraft elevate that “will get them off the desk 3 hours previous.”
4. The deep structural neck elevate
In recent years, each time I open Instagram, I land on a lecture about submandibular glands and the significance of contouring them to take a neck elevate to the following stage. (I practice plastic surgeons the best way standard folks do celebrities.) Inevitably, digastric muscle tissue and subplatysmal fats input the chat. (Once more, my echo chamber, er feed, would possibly glance a bit other than yours.)