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Endoscopic correction as a secondary operation

In this article, we will find out why patients who have already been operated on often come for endoscopy.

Published at

March 29, 2024

How are endoscopic surgeries fundamentally different from other surgeries?

With age, due to gravitational changes, the central oval of the face slides down. As a result, the volume of the face mask is shifted, and the face is visually flattened. It is not enough to stretch the surface tissues of the facial mask to create the impression of a young face. Tension will only exacerbate the "flat face" effect characteristic of age-related changes.

To achieve the desired effect, it is necessary to move the volumes shifted downwards and fix them in an aesthetically advantageous position. This principle is the essence of endoscopic plastic surgery. During endoscopy, the tissues of the facial mask are separated by a single block from the fixed structures of the skeleton, moved and fixed according to the indications and wishes of the patient. Thus, the technique makes up for the missing and lost volumes in the central oval of the face, taking into account all the difficulties: the peculiarities of anatomical development and facial expressions, as well as the three-dimensionality of the facial structure.

A unique technique

Age is not the main thing

Endoscopy is a technique. It allows you to perform many variations of correction, so it adapts to the needs of any patient: from 18 years old to 70+. Anatomical features are corrected at a young age, and gravitational changes of varying severity occur at a more mature age.
Each case requires a unique solution and approach, so a surgeon who knows the endoscopic technique uses various maneuvers.

We take care of fabrics from a young age

During endoscopic operations, surgeons at OLYMPUS CLINICS, first-class adherents of endoscopy, do not use additional devices to fix tissues, so nothing is brought in from the outside. Moreover, endoscopy provides a unique opportunity not to remove facial tissue: it is often enough to restore volumes so that the skin, supposedly "superfluous" and "stretched", straightens and tightens on the restored volumes.

Without incisions on the face and postoperative signs

Incisions up to 2 centimeters are performed in inconspicuous places: in the scalp and/or in the mouth from the mucous membrane. They play the role of technical access points for the introduction of an endoscope and special tools into the necessary deep layer of the facial mask. Due to the deepest possible detachment, scar tissue does not form superficially, which allows you to preserve the naturalness of facial expressions and avoid deformations.

The visibility is impeccable

Thanks to a special video camera, the surgeon penetrates into the desired layer of the facial mask and performs tissue detachment with special tools using an image displayed on a monitor and magnified tenfold – not under direct eye control. The surgeon clearly sees all the structures he works with and controls the process as much as possible.

What tasks does endoscopy cope with?

Endoscopy can be performed as a beautician technique that replaces contouring. You no longer have to adjust the contours and facial features from time to time. Byutifying endoscopic corrections allow you to choose your own set of necessary manipulations and achieve a stable effect for an average of 10 years. With its help, you can change the position of the eyebrow, improve the upper eyelid area, ease its crease, open the gaze, move the corner of the eye, visually tighten the temporal part, transform the zygomatic area.

As a rejuvenating operation, endoscopy is also able to solve many tasks: eliminate wrinkles in the forehead, between the eyebrows, around the eyes, remove the feeling of excess skin on the upper and lower eyelids, smooth out the relief under the eyes, redistribute fat packages, tighten and smooth the transition zone from the lower eyelid to the cheekbone, correct the volume loss of the middle zone, straighten the nasolabial folds, move the volumetric accents from the lower part of the cheek to a higher position.

An individual combination of actions is always selected at the consultation.

Endoscopy of the upper third of the face allows you to change the position of the eyebrows, tighten the temporal part, improve the appearance of the upper eyelid, lighten the area of the chin, open the eyes.
It often replaces an outdated technique — upper blepharoplasty.

Periorbitoplasty is an improved alternative to circular blepharoplasty.
The technique allows you to eliminate the feeling of excess skin on the upper eyelid, lift the corners of the eyes, eyebrows. Smooth out the relief under the eyes, redistribute fat packs without removing them. Tighten and smooth the transition zone from the lower eyelid to the cheekbone, tighten the zygomatic and temporal parts.

Endoscopy of the middle zone of the face corrects excessive relief, separation and visualization of fat packages of the lower eyelid, gravitational changes in the middle cheek and loss of volumes of the middle zone. The boundaries between the lower eyelid, cheekbone, and cheek are smoothed, nasolabial folds are straightened, the zygomatic zone is tightened, and volumetric accents are moved from the lower cheek to a higher position. The feeling of excess skin on the lower eyelid disappears.

Let's look at two of the most popular cases when patients seek endoscopy after primary aesthetic facial surgery

Case 1
A classic of the genre: a patient with age-related changes in the face and neck turns to a surgeon, she is offered a "facelift" / SMAS-lifting (a lift with a scar around the ear). Whether it's a "high" SMAS, a "deep" Mendelssohn method, a "circular" or an author's lift — it doesn't matter. Any variation of the SMAS technique will always be aimed at correcting the lateral parts of the face and neck. After surgery, the neck may become perfect, and the oval of the face may become clear, but the rejuvenation effect will remain unattainable.

The success of the operation in the patient's understanding is not measured by the amount of skin removed or the degree of tension of the oval. Success is measured by how much and how the overall impression of the face has changed. What determines the overall impression of the face? Depends on the condition of the central oval. The presence of relaxation changes in the lateral parts of the face and neck is not corrected by endoscopy, however, this does not mean that working only with the lateral parts of the face and neck will be enough to achieve an optimal, rejuvenating effect. It is the effect on the central part (frontal plane) that allows you to achieve rejuvenation.

Case 2
The problem of visualization of deep fat packages of the upper and lower eyelids is quite common. The lack of their visualization and relief is a sign of youth.
Patients with this problem most often turn to classical blepharoplasty, in which fat packets are resected. Why is this bad and what does it threaten?
The "hernias" of the lower and upper eyelids are nothing more than fat packs, anatomical units that everyone has normally. They are located in the orbit (orbit), surround the eyeball and are limited by the connective tissue septum. 
The dense and elastic septa relaxes over time and becomes more flabby. Because of this, the fat bags of the upper and lower eyelids begin to "bulge out", form an ill-fated relief and "bags" under the eyes or above the eyes.
The cavity of the orbit is unchanged, that is, its initial volume does not change with time. Therefore, the decrease in the volume of fat packages will be compensated by the movement of the eyeball deeper. With age, without any surgery, we already get a similar effect. Due to bone resorption, the orbit becomes larger, and the eyes become visually smaller. Therefore, it is short-sighted to remove fat bags.
It is necessary either to redistribute and move fat packages to smooth out excessive relief and maintain volume, or not to touch fat packages at all, but to move more superficial structures. The endoscopic technique perfectly copes with this. Therefore, often, having received not the most desired result after blepharoplasty, patients come for an endoscopy.

This applies not only to the problem of visualizing the fat packs of the eyelids. According to a number of other (allegedly) "indications" for blepharoplasty, the endoscopic technique becomes an indispensable way of the most correct exposure (or correcting the consequences of the primary, incorrectly selected or outdated technique).
The classical technique of eyelid surgery always acts more aggressively, pointwise and superficially. The circular muscle of the eye, the skin, and fat bags can be partially resected. Since the eyelid area is very delicate, in most cases such actions leave behind the stigmas of the operated type: skeletonization of the upper edge of the orbit, excessive depression of the fold of the upper eyelid, A-shaped deformation, rounding of the outer corner of the eye.
It is necessary to realize that we do not age in "pieces", and age-related (=gravitational) changes, including the area around the eyes, are associated with the fact that the tissues of the facial mask literally "slide" down. For a harmonious and full-fledged transformation, you need to work with volumes, i.e. resort to "endoscopy".

Endoscopic techniques are universal. They are suitable for any morphotypes of the structure. Endoscopy is minimally invasive and delicate for a number of reasons, the main of which is tissue preservation. That is why this technique often becomes the best solution, including after the initial operation, the effect of which did not give the desired result.

No matter how difficult your case may be, the specialists of OLYMPUS CLINICS with their multifaceted capabilities will choose the best way and lead you to the long-awaited result.

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