Endoscopic Plastic Surgery

Endoscopy is a surgical technique that involves the use of an endoscope, a special viewing instrument that allows a surgeon to see images of the body's internal structures through very small incisions. The endoscope consists of two basic parts: a tubular probe fitted with a tiny camera and bright light, which is inserted through a small incision; and a viewing screen, which magnifies the transmitted images of the body's internal structures. During surgery, the surgeon watches the screen while moving the tube of the endoscope through the surgical area.
Advantages of endoscopic surgery include smaller incisions and quicker recovery time from surgery. In a typical endoscopic procedure only a few small incisions, less than an inch long, are necessary. For some procedures, such as breast augmentation, only two incisions may be necessary. For others, such as a forehead lift, three or more short incisions are needed. Depending on the procedure, endoscopic surgery is usually performed on an outpatient basis under local anesthesia with sedation.

Some cosmetic procedures that can be done endoscopically include:

Abdominoplasty (tummy tuck)
Endoscopy is sometimes used as an adjunct for selected patients who have lost abdominal muscle tone. Guided by the endoscope, the muscles that run vertically down the length of the abdomen may be tightened through several short incisions. Endoscopy is generally not used in patients who have a significant amount of loose abdominal skin.

Breast Augmentation
An endoscope, inserted through a small incision in the underarm or navel, can help a surgeon position breast implants within the chest wall. Endoscopy may also assist in the correction of capsular contracture (scar tissue that sometimes forms around an implant and causes it to feel firm) and in the evaluation of existing implants.

Facelift
While the traditional facelift operation is still the best choice for most patients, certain individuals may benefit from an endoscopically assisted procedure. Using endoscopy, the incision along or in the hairline is usually eliminated. Instead, small incisions may be placed in areas where the most correction is needed. For example, if the muscles and skin of the mid-face need to be smooth and tightened, incisions may be hidden in the lower eyelid and in the upper gum line. The endoscope may also help in the positioning of cheek and chin implants.

Forehead Lift
The forehead lift is one of the most common endoscopic procedures performed by plastic surgeons. Instead of the usual ear-to-ear incision, three or more small incisions are made at the hairline. The endoscope help guides the surgeon, who removes the muscles that produce frown lines and repositions the eyebrows at a higher level.

Endoscopy is also used for reconstructive surgery, such as flap surgery, placement of tissue expanders, sinus surgery and carpal tunnel release:

Flap Surgery
Endoscopy can assist in repairing body parts that are damaged from injury or illness. Often, healthy tissue is used from one part of the body to help repair another. Using an endoscope, the tissue or flaps can be removed from the donor site with only two or three small incisions.

Placement of Tissue Expanders
Used often in reconstructive surgery, tissue expanders are silicone "balloons" that are temporarily implanted to help stretch areas of healthy skin. This newly expanded skin is then used to cover body areas where skin has been lost due to injury (such as burn) or disease. Using an endoscope, a surgeon can help ensure that a tissue expander is correctly positioned beneath the surface.

Carpal Tunnel Release
After the endoscope is inserted through a small incision in the wrist area, the surgeon locates the median nerve that runs down the center of the wrist. A separate incision may be made in the palm to insert scissors or scalpel to cut the ligament putting pressure on the nerve.