This article demonstrates the efficacy of endoscopic techniques in tot
al facial rejuvenation. The author has introduced the total subperiost
eal dissection to the endoscopic forehead lift. This concept has been
extended to the rejuvenation of the central and lower third of the fac
e. Patients up to the late 40s can have a total facelift without skin
excisions. In older patients, the introduction of endoscopic technique
s helps to minimize some of the undesirable sequelae of the traditiona
l open procedures such as alopecia, scalp paresthesias, and facial ede
ma of the subperiosteal lift. The author also introduces a new, more e
fficacious method of midface suspension.