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Then, the skin of the forehead is lifted away from the underlying muscles. The excess skin is trimmed away, and the skin cut is closed with stitches. This technique causes much bleeding and remarkable scars. Another technique that I always use is modern endoscopic forehead lift. In this procedure, 2 cm in length 4 skin cuts behind the hairline are done; an endoscope is placed under the skin in order to get a clear view of the muscles and tissues under the skin. Then the surgeon inserts another instrument through a separate skin cut to lift the forehead skin and remove or alter the muscles and underlying tissues. The forehead skin is tacked up in a higher position. This technique causes much less bleeding and much less scars. Mid-face lift is aimed at lifting the cheeks and tightening the cheek skin. Cheeks sag together with muscles, fat tissue and skin. If this procedure is done as tightening the skin alone, sagging of the muscles and fat tissue is only camouflaged and effectiveness is lost within the short period.
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