Endoscopic surgery

In surgery, every incision leaves a scar. In endoscopic surgery, scars are minimized and may be completely hidden. Dr. Chartchai need to make only a few very small incisions to perform the procedure.

Endoscopic surgery, while having been used for decades in general surgery, is used in a limited way in cosmetic and reconstructive surgery. Endoscopy is a surgical technique using a special viewing instrument called an endoscope.

Patients who tend to be the best candidates for cosmetic endoscopic procedures are those who don't have large amounts of loose hanging skin. Patients with loose facial or abdominal skin may benefit from a combination of classic and endoscopic techniques, in facelift or forehead lift , or abdominoplasty.

Endoscopic procedures may sometimes be performed on an outpatient basis under local anesthesia with sedation. Dr. Chartchai will advise if this is possible.

Procedures
In cosmetic surgery, the brow lift or forehead lift is the procedure most commonly performed using the endoscope. When an ear-to-ear incision is not acceptable, typically with men who have a thinning hairline, several small puncture incisions are made just within the hairline.

Endoscopic surgery may sometimes be used for certain patients during an abdominoplasty if there is a very small amount of loose abdominal skin.

For a few patients, it may be possible to perform a cheek lift or mid-face lift endoscopically and hide the incisions behind the hairline and within the upper gum.

To tighten loose platysma muscles of the neck, incisions may be concealed beneath the chin and behind the ears, as long as there is minimal loose skin that doesn't need to be excised.

Recovery time
The incisions are shorter so the risk of sensory loss from temporary nerve damage is lessened. Bleeding, bruising and swelling may be significantly reduced, and patients may recover more quickly and return to work earlier than with a traditional brow lift.

Special considerations and risks
While Dr. Chartchai was trained at U.C.L.A. in Los Angeles in the use of the endoscope for cosmetic surgery and reconstructive surgery, he emphasizes that the endoscope has only relatively recently been applied to plastic surgery procedures.

There are some known risks, which vary in severity depending on the procedure being performed. These include infection, fluid accumulation beneath the skin (which must be drained), blood vessel damage, nerve damage or loss of feeling, internal perforation injury, and skin injury.