Expert Doctor

Endoscopic Facelift

Bryan Gawley, MD

Scottsdale, AZ

Endoscopic Facelift

An endoscopic facelift is a facial procedure done through relatively small incisions to address the issue of excess fatty tissue and sagging facial muscles. In a traditional sense, an endoscopic facelift typically refers to an endoscopic mid-facelift or an endoscopic cheek lift. Compared to a traditional facelift, an endoscopic facelift is a less invasive and less expensive alternative to address the signs of aging in the face and neck. The procedure utilizes incisions, placed behind the ear or above the hairline, that are less than an inch long to tighten the facial muscles and remove fatty tissue.

Am I A Good Candidate For Endoscopic Facelift?

People that are GOOD CANDIDATES for an endoscopic facelift include:

  • Someone that has early signs of aging as well as a lack of laxity in the lower face and their neck
  • People that already had a facelift and feel that their cheek area is falling
  • Someone who is (relatively) younger and is starting to see signs of aging in the cheek area which makes the person interested in a brow lift
  • People in their 30s-50s who have mild facial imperfections due to excess fatty tissue and loose facial muscles

Patients that are NOT GOOD CANDIDATES include those who:

  • Have heavier faces
  • Are overweight
  • Do not have realistic expectations about the results
  • Are not in general good health

How Is An Endoscopic Facelift Performed?

As opposed to the continuous long incisions made during a conventional facelift, the three incisions of an endoscopic facelift are less than an inch in length. These incisions are placed above the hairline or, if possible, behind the ear. A long, thin tube is inserted that has a lighted camera located on its end. The camera allows the surgeon to better view the underlying structures below the skin. Small surgical instruments are then used to tighten any facial muscles that are sagging as well as remove excess fatty tissue to create a look that is contoured and firmer.

Unlike a traditional facelift, an endoscopic facelift does not address any problems with excess skin. However, the procedure can address and resolve some of the factors that contribute to drooping and sagging skin on the face thanks to the reshaping of the underlying structure. Thanks to the small incisions used near the hairline and ears that can easily be hidden, an endoscopic facelift is sometimes called a “scarless facelift”.

Standard Facelift:

A standard facelift tightens the neck and the jowls by removing skin in front of, and behind, the ear. The surgeon makes a large incision right in front of the ears to remove the skin and place some suspension sutures in the jowl. An endoscopic approach would not be the best method to lift the jowl as it specifically deals with the cheek area and suspends the cheek upwards. People that have problems with the lower face and the neck are going to need more of a traditional facelift that leaves a scar behind the ear. Someone that wants a natural-looking and comprehensive facial rejuvenation can lift the mid-face with an endoscopic mid-facelift and combine it with a traditional facelift to tighten up the jowls and the neck.

Endoscopic Brow Lift:

Another procedure that is commonly combined with an endoscopic facelift is an endoscopic brow lift. The tissues are elevated off the cheek bone and small incisions are used to place suspension sutures to suspend the cheek tissues and give a lift in the mid-face area.

What Is The Cost Of An Endoscopic Facelift?

The cost depends on the type of facelift performed as well as the geographic location of the surgery and any fees charged by the doctor or the facility. The cost of a traditional facelift can range from $5000-$25,000 while an endoscopic facelift runs from $6000-$10,000.

Recovery and Downtime

In general with endoscopic procedures, there is less RECOVERY because there are not as many incisions. The endoscopic approach has hidden and small incisions in the hair so there is not a significant amount of sutures that have to be removed.

Any type of facial surgery will require a week or two of social downtime because of bruising and swelling. An endoscopic mid-facelift has 10 days of social downtime and a full facelift has 14 to 20 days. Any swelling and bruising typically resolves itself after two weeks. However, many patients go back to work after one week if they don’t mind others seeing the remaining swelling and bruising.


Even though an endoscopic facelift can improve the look of sagging facial muscles and excess fatty tissue, it is often performed on a younger patient so the final results might be less noticeable because of the age of the person. In general, the results should last at least 5 to 10 years. The procedure can improve the appearance of a patient but it cannot stop the aging process or the effects of gravity.

Since the endoscopic procedure does not remove any skin, and is done through small incisions, the patient might have too much of a subtle improvement if it is not combined with a standard facelift. The results last fewer years than a full facelift that lasts 7 to 15 years. The longevity of the results is not as great with an endoscopic procedure.

Limitations and Risks of Endoscopic Facelift

The main LIMITATION of an endoscopic facelift is the fact that there will not be drastic results because the surgeon is not removing any of the skin. An endoscopic facelift typically addresses looseness in the cheek area. It is not a good option for areas with excessive amounts of skin such as the lower neck.

The other limitation is related to the fact that the patient will not see the same drastic results as a standard facelift. The longevity of the results is limited by the way the procedure is performed.

The RISKS associated with endoscopic facelift include:

  • Bleeding
  • Infections
  • Under-correction of the treated area since there is not any skin removal

How to Determine the Correct Procedure

An endoscopic facelift has results that are more subtle in appearance because there is no skin removal as well as no visible scars. This is in direct contrast to a traditional facelift that tightens the neck by removing skin from around the area of the ears. Before having any kind of facelift performed, a patient needs to schedule a consultation with a board-certified surgeon who can match the patient to the right procedure in order to achieve the desired results.


Written by Cosmetic Town Editorial Team - MA

Based on an exclusive interview with Bryan Gawley, MD in Scottsdale, AZ