Along with the term endoscopic lifting, the term mini-lifting is also much used: however, we need to be clear about the fact that mini-lifting does not mean a reduced or simplified lifting, nor does it mean a lifting that can be done during a lunch break. Thus, endoscopic lifting is not a mini-lifting, but rather a real and true complete lifting of the face and thanks to endoscopic techniques, we can obtain better results than with the old surgical techniques in use some years ago.
The advent of the endoscope, an optical tube equipped with a micro camera, has enabled the surgeon to visualize the images taken during a procedure on a screen. This is a revolution in surgical procedure because it allows the user to work in spaces so restricted and in ways that were unimaginable before.
What Endoscopic Lifting Does
The forehead and the eyes are areas of fundamental importance to the appearance of the face for both men and women. The combined actions of sunlight, of time, and often of stress cause the formation of wrinkles in the region of the forehead and a lowering of the line of the eyebrows, which gives a tired and exhausted look to one’s appearance.
When we perform a lifting procedure on the area around the eyes, we obtain a result which is certainly aesthetically important and which goes beyond a simple improvement in your looks, because this area is crucial in transmitting to others a more pleasant aesthetic appearance.
The eyebrows and the eyelids are of great importance in the aesthetics of appearance. An endoscopic surgical procedure in this region can eliminate the wrinkles of expression and reposition the eyebrow line to its natural level, thereby restoring freshness and luminosity to the appearance. In the same procedure, this technique can be associated with others, such as blepharoplasty. Thus, endoscopic lifting has a completely different philosophical approach: however, one that requires the highest level of technical training, and if correctly performed, is able to ensure surprising aesthetic results.
How Endoscopic Surgery Combats the Force of Gravity and the Loss of Adipose Tissue
It was invented in the 1990s in the United States by Nicanor Isse and brought to Italy by Alessandro Gennai. The technique starts from the modern analysis of changes in the face, thanks to which it was made evident that there are fixed zones corresponding to ligaments, subcutaneous attachments, where there is no sagging and other zones, where the subcutaneous tissues, having fewer attachments to the deep tissues, tend to sag or fall due to the force of gravity. This sagging, caused by gravity, is determined above all by an impoverishment of the subcutaneous adipose tissue, which is to say, a loss of fatty tissue and in consequence a loss of volume, as well as by the reassorbment of the bone. This explains the obsolescence of all the surgical techniques which depend upon ample skin removal or resection, use the lateral part of the face as tensile carriers and do not include restoring the lost volume to the face.
The Endoscopic Technique
As previously stated, the advantages of an endoscopic procedure over a traditional lift principally consist of results that are decidedly more natural and in avoiding some unpleasant phenomena that can occur with traditional lifting, such as a stretched appearance from excessive pulling of the skin, visible scars and hollow faces without volume. The surgeon uses an endoscope, an instrument equipped on its point with a telecamera only 4 millimeters in diameter, which registers what occurs under the skin and reproduces it on a monitor. The entire procedure is performed using the monitor and this is why it is fundamental that the operator has a great mastery of surgical technique.
4 or 5 incisions of one and a half centimeters each are made on the top of the patient’s forehead without the necessity of cutting the hair and without leaving visible scars. Along with the endoscope, through these incisions, functional micro instruments are introduced, which allow one to work on the anatomical structures of the tissues with great precision. The tissues are then repositioned leaving the facial characteristics unaltered and we proceed with the restoration of volume by using grafts of adipose tissue, harvested from other parts of the body in a preceding procedure.
MIVEL or Minimal Incisions Vertical Endoscopic Lifting procedure
The in-depth study targeting facial anatomy has permitted us to acquire important knowledge of the aging dynamics of the face; thanks to this acquired knowledge, we now know it is more correct and functional to divide the areas of the face into vertical areas (central, medial and lateral) and into districts (frontal, periocular and cervical chin). MIVEL procedure is performed by endoscopic equipment: with a very thin camera (it’s thinner than a pen!) the surgeon can visualize the anatomical structures and reposition them through minimal incisions.
After repositioning the tissue the surgeon proceeds to restore and regenerate tissue by injection of autologous adipose tissue and ADSC (adipose derived stem cells).
This technique is called SEFFI (Superficial Enhanced Fluid Fat Injection). This fat is harvested from the patient through a very thin cannula (2 mm with holes of 0.5 mm) in local anesthesia. The procedure is performed under local or general anesthesia and the patients can return home on the same day of surgery.
In the days after surgery, the patient has to follow the surgeon’s prescription. Some swelling and bruises can occur and the patient has to avoid sun exposure until they disappear. Usually, the patient can return to work in 7-10 days. The best result will be in 20 days.
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