By combining three established minor surgical procedures, the facial aging of middle aged women and men can now be corrected without a visible scar.

Procedure 1: Endoscopic brow lift
The approach to surgery of the upper face has been advanced by the endoscope, a special viewing instrument that allows the surgeon to see inside the body through very small incisions. The endoscope contains a tiny camera. As the surgeon moves the endoscope through the surgical area, the image is viewed on a television screen. Miniature instruments are used to make the desired changes.

Endoscopy has been used for many years in other medical specialties for knee cartilage repair, gall bladder removal, and “Band-Aid” tubal ligation. When the endoscope is applied to the brow and upper face, very small incisions are made in the scalp behind the hairline to perform surgeries that in the past were performed through longer skin incisions.

The attachments of the soft tissues of the forehead and upper face are freed and elevated in such a manner as to create a fresher, more youthful contour to the eyebrows and to reduce the heaviness which can make the upper eyelids look too heavy.

Procedure 2: Midface Rejuvenation
Corrections of the aging of the cheeks and the deepening of the folds between the nose and mouth (nasolabial folds) are made through small incisions which are made inside the mouth above the canine tooth on each side. The soft tissues of the midface which drop with age are freed from their attachments to the bone and repositioned at a higher, more youthful level. This alleviates the fatigued and “jowly” look of the aging face.

Procedure 3: Neck Recontouring
Through a small incision in the crease under the chin, the excess fat along the jawline and in the neck is removed using micro-liposuction. The sagging muscles of the neck (the platysma) are tightened as they were in youth. A firm jawline and neckline are perceived as signs of youth and beauty. Now they can be improved without the need to remove excess skin.

By combining endoscopic brow lift, subperiosteal midface elevation and neck recontouring into one procedure, the signs of aging- the lowering of the brow, the crowding of the upper eyelids, midface sagging, jowl formation, and loss of neckline and jawline- can be dramatically improved without the need to remove skin. Consequently there are no scars other than the small ones in the scalp and the one hidden under the chin. In the older patient, when there is an obvious excess of skin, a traditional facelift should be considered. However, the scarless facelift is for the younger patient, 35-50 years of age, who is exhibiting the earlier signs of an aging face.

With this approach plastic surgery can turn back time with no visual scars. This allows the middle-aged patient to regain their normally youthful look.