The practice of cosmetic and reconstructive plastic surgery is constantly evolving, with new techniques and advanced technological tools appearing all the time. In the nearly thirty years that I have been a board certified plastic surgeon and otolaryngologist, I have found that one of the most useful of these innovations is the fiber optic technology that makes endoscopic surgery possible. By using a tiny camera mounted to a tubular probe, endoscopic technology makes it possible for surgeons to perform complex and detailed work underneath the skin and tissues using only a handful of very small incisions. Although endoscopic techniques have been used for decades in a number of different procedures, ranging from gallbladder removal, to tubal ligation, to knee surgery, their use in plastic surgery is still relatively new. However, they have proven to be both highly effective and extremely versatile. While an endoscopic approach is not appropriate for all plastic surgery procedures, and may not necessarily be advisable for use with all patients, in situations where it is possible it can significantly reduce post-surgical recovery times, minimize bruising and scarring, and generally achieve extremely satisfactory results.
Whenever the skin is cut or manipulated, some sort of mark, like a bruise or a scar, will be left behind. Hence a major challenge of cosmetic plastic surgery procedures is to make the alterations that the patient desires while causing as little disruption and damage as possible. This is particularly true during facial plastic surgery procedures, when significant scarring or bruising cannot be easily hidden beneath clothing. Endoscopic techniques can make it easier to successfully meet that challenge by reducing surgical incisions. For example, a traditional brow lift procedure, designed to reduce wrinkles and deep furrows on the forehead, once required the use of a coronal incision, running from ear to ear across the top of the scalp. This long incision could, in some patients, cause unsightly scarring or even damage the hair follicles, which could in turn compromise the growth of hair along the scar line and potentially make the resulting scar even more visible. Today, I commonly perform an endoscopic brow lift using an advanced “key-hole” technique. This allows me to see and access the tissues and muscles in the brow using only a few small incisions, each less than one inch long, that are easily concealed in the hairline. Similar endoscopic techniques can also be used to improve the results of mini-facelift procedures, which address sagging and facial aging in the area beneath the eyes and above the jawline, as well as in certain forms of nasal surgery.
The use of smaller incisions significantly reduces bleeding, bruising, and swelling during and after a plastic surgery procedure, and also decreases the risk of longer incisions damaging the underlying nerves and causing sensory loss. With an endoscopic approach, patients usually enjoy faster plastic surgery recovery times and are able to return to their normal activities sooner than if they had undergone a more conventional procedure. In some cases, endoscopic procedures can even be performed on an outpatient basis, using only local anesthesia. This may allow patients to avoid an overnight hospital stay.
As with any plastic surgery procedure, it is important to remember that every patient is unique and has their own individual requirements, so a personal consultation is necessary in order to determine the specific surgical approach that is most appropriate. If you have questions about any of the cosmetic or reconstructive plastic surgery procedures that I perform, please feel free to contact me, Dr. Fernando Burstein, to schedule an appointment for a full consultation so that we can discuss your particular goals and needs and examine computer-generated images of what your potential results will likely be. Don’t forget to connect with me on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.