In response to Dr. Talei, who doesn’t carry out endoscopic facelifts however is famend for his deep airplane experience, older endoscopic methods that tunneled all the way down to bone precipitated tons of swelling and produced outcomes that lasted, on most individuals, a few 12 months and a half. However the extra novel and “technically difficult” endoscopic deep airplane facelifts might be “a very good possibility for choose sufferers who don’t want an enormous elevate,” he says. “They’re not simply advertising.”
As this process’s approval score 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, analyzing 600 consecutive ponytail instances over 22 years, will sway “naysayers who say it would not work or is just for younger folks.”
Dr. Kao affords 4 distinct “ponytail” operations, every designed to sort out an growing diploma of laxity. Whereas his youngest (and tautest) sufferers depart the OR with simply 4 tiny slits hidden of their hair, these of their mid-40s, 50s, and 60s might have further incisions behind (or, not often, 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 the way in which all the way down to the angle of the jaw via incisions within the temple space,” a maneuver that “got here to me possibly 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 serious facial nerve. Finally, inspiration struck because it so usually does: “I figured it out within the bathe.”
Dr. Mani’s endoscopic approach mimics his standard deep airplane strategy, save for the incisions, which he conceals within the hair of the temples and behind the ears (sparing the scar in entrance of the ears). Not like Dr. Kao, who performs ponytail procedures solely, Dr. Mani operates endoscopically in 60% to 70% of sufferers. He’ll in any other case carry out an everyday deep airplane facelift with conventional incisions.
Each docs say the longevity of their endoscopic lifts rivals that of ordinary deep airplane procedures and that complication charges and restoration durations are nearly similar. When talking of security, Dr. Mani tells me that the endoscope really offers him an edge by making “the nerves appear like big snakes,” so he can keep away from them extra simply.
Nonetheless, navigating an endoscope—a talent not each surgeon possesses—can delay an already prolonged process. Dr. Kao’s most complicated facelifts can take 10 to 12 hours, twice the time of a typical deep airplane facelift. Some view this as a possible disadvantage, notably for older sufferers who finally wind up needing incisions in entrance of the ears anyway, the very factor they’re aiming to keep away from with an endoscopic elevate. If there’s a risk that these incisions will probably be essential to take away extra pores and skin, says Dr. Nayak, the affected person could also be higher off with an everyday deep airplane elevate that “will get them off the desk three hours earlier.”
4. The deep structural neck elevate
These days, 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 subsequent stage. (I comply with plastic surgeons the way in which regular folks do celebrities.) Inevitably, digastric muscle mass and subplatysmal fats enter the chat. (Once more, my echo chamber, er feed, might look a bit completely different than yours.)
