Good aesthetic results have been obtained by all the open approaches with subperiosteal, supraperiosteal, or biplanar forehead lift, however, they have the disadvantage of leaving a long transverse scar with associated wound problems, also, other sequelae such as hematoma, alopecia, numbness beyond the incision line and itching are not uncommon. The introduction of endoscopic technique helps to minimize some of the undesirable sequelae of the traditional open procedures, minimizing the facial and scalp scars, moreover, having the equivalent results.
Most of my endoscopic forehead lifting cases were done with technique of subperiosteal dissection (further details will be discussed). Usually no major complications as motor nerve injury or hematoma were noted. Some transient sequelae as forehead paresthesia and anesthesia can be happened, but all these cases recovered after desensitization for a few months. Few had temporary perifocal alopecia over the incisional scars which recovered few months later and these cases were decreased after using protective ports. During the process, lifting of the midface can also be done simultaneously through the temporal incisions. The dissection can be carried down along the lateral orbital rim into the malar region and down into the midface in a subperiosteal plane under the guide of the endoscope with or without intraoral incisions. Tension free reposition and rigid fixation are very important in the prevention of early relapse; all of the margins over the periformis aperture, infraorbital rim, buttress of the maxilla and anterior two thirds of the zygomatic arch must be totally released, so that the whole midface could be lifted up as a composite flap, thus the ogee lines could be restored without a great tension.
The use of the endoscopic technique allows improved visualization and even magnification, with the benefits of reduced incision length and reduced dissection. As a result of the reduced tissue trauma, postoperative morbidity may be significantly reduced with a rapid return of the patient to a normal functional status.

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