Subperiosteal facelift: open and endoscopic approach.

The endoscopic subperiosteal facelift as an isolated procedure is indicated for patients with grade I rhytidosis. It is also indicated in cases of grades II and III rhytidosis in males in whom the coronal incision is contraindicated due to alopecia and without conspicuous damage to the forehead. In these cases, the procedure is combined with subcutaneous rhytidectomy of the neck. It can also be used in cases of secondary facelift. The small incisions used in this procedure allow sufficient and effective access for dissection and suspension of the tissues released during the facelift. The coronal incision is not necessary, thus avoiding the resulting discomfort and scar. These patients do not receive anesthesia and experience almost no paresthesia in the frontal region, as in cases in which a coronal incision is performed. The endoscopic approach reduces surgical trauma as well as postoperative edema. Since neither the veins nor the lymphatic vessels of this area are sectioned, swelling subsides faster and recovery is shorter.