An endoscopic deep plane facelift aims to lift the mid and upper face vertically by working with a camera through small incisions in the scalp and temple and releasing the deep plane beneath the SMAS. This page covers who it suits, how it differs from an endoscopic facelift and a deep plane facelift, recovery, risks and the process in Istanbul.
| At a Glance | Details |
|---|---|
| Procedure | Endoscopic deep plane facelift — camera-assisted lift of the mid and upper face |
| Duration | 2–4 hours |
| Anesthesia | General (sometimes sedation + local) |
| Where it is done | Hospital operating room (Memorial Göztepe Hospital, Istanbul) |
| Hospital stay | 1 night |
| Back to social life | 7–10 days; heavy activity ~3–4 weeks |
| Scars | Small incisions in the temple and scalp |
| How long it lasts | A long-lasting effect is the aim; ageing continues |
| Who it suits | Midface descent with good skin, in good health |
Contents— 22 sections
What Is an Endoscopic Deep Plane Facelift?
As we age, the midface fat pads and cheek descend, flattening the cheek, deepening the nasolabial folds and pulling down the brow and temple. A skin-only or purely lower-face lift does not correct this vertical descent well.
The endoscopic deep plane approach addresses this in two ways. First, a fine camera passed through 1–2 cm incisions within the hairline lets the surgeon work without a long facial incision. Second, the lift is done in the deep plane — the surgeon releases the retaining ligaments beneath the SMAS so the tissue can move freely upward, which is the natural direction of rejuvenation.
This page covers the approach in which endoscopic access and a deep plane release are used together; it is also known as an endoscopic midface lift. If the problem is mainly in the lower face, jowls and jawline, the deep plane facelift page is more relevant; if it is only the forehead and brow, see endoscopic facelift. For the neck it can be combined with a deep plane neck lift.
Technique & Facial Layers
The essence of the operation is the plane in which the lift is done. Working beneath the SMAS (in the deep plane) allows the midface to be moved vertically:
Camera-assisted, small incisions within the scalp; a vertical lift of the mid and upper face. Considered for midface descent.
For the lower face and jawline through an incision around the ear; considered for jowls and jawline sagging. More: deep plane facelift.
Similar small incisions focused on the forehead and brow. More: endoscopic facelift.
Fold or trim the SMAS; a classic option for moderate lower-face sagging.
The effect of threads and fillers is temporary; they do not reposition a descended midface. Marked midface descent needs a surgical lift.
Which Facelift When? Endoscopic, Deep Plane and Combined Approach
The right technique depends on where the sagging is concentrated. The drawings below show three typical patterns; they do not measure your face or make a diagnosis. Which procedure is needed is decided at the examination.
With good skin quality and early flattening of the midface, an endoscopic approach may be considered. If the problem is only the brow and forehead, an endoscopic facelift may be more suitable.
A flattened cheek and deepening nose-to-mouth folds are the pattern an endoscopic deep plane approach targets; if volume loss is also present, fat injection can be added.
If the jowls, jawline and neck also sag, an endoscopic midface lift alone is not enough; a deep plane facelift and, if needed, a neck lift are planned.
Other facelift pages: facelift (overview) · deep plane facelift · endoscopic facelift · neck lift
Who Is a Good Candidate — and Who Is Not?
Suitable candidates
- Midface descent, cheek flattening and deep nasolabial folds
- A descended brow/temple with good skin quality
- People who do not want a long incision in front of the ear and whose problem is mainly in the midface
- Non-smokers or those able to quit, with realistic goals
Situations to postpone/assess
- Very advanced lower-face jowls and neck laxity (a classic deep plane may suit better)
- Uncontrolled chronic illness or a bleeding disorder
- Active smoking (wound-healing risk)
- Expecting a change in the neck this technique does not target
An endoscopic deep plane facelift aims to reposition the midface and brow; the neck and jawline are addressed with complementary procedures when needed.
Endoscopic vs Deep Plane Facelift: What Is the Difference?
| Technique | Target area | Scars | Recovery |
|---|---|---|---|
| Endoscopic deep plane (this page) | Midface & brow descent | Small, within the scalp | 7–10 days |
| Deep plane facelift | Lower face, jowls, jawline | Around the ear | 10–14 days |
| Endoscopic facelift | Forehead & brow | Small, within the scalp | ~1 week |
| Thread lift | Very mild laxity (temporary) | Small entry points | 2–3 days |
In short: endoscopic deep plane for a dropped midface and brow; when the jowls and jawline dominate, a deep plane facelift through an incision around the ear is considered. The techniques are not interchangeable; the examination decides.
How Is an Endoscopic Deep Plane Facelift Performed? (Step by Step)
Access through small incisions
The endoscope is introduced through 1–2 cm incisions in the temple and scalp; no long facial incision is made.
Deep-plane release
Under camera guidance the retaining ligaments are released beneath the SMAS so the midface can move.
Vertical lift & fixation
The cheek and brow are lifted vertically and fixed; the small incisions are closed with sutures.
Planning and vectors
Anesthesia
Endoscopic access
Deep-plane release
Vertical repositioning
Closure and dressing
Recovery — Day by Day, Week by Week
Because the incisions are small, recovery is often shorter than with a lift that also covers the lower face and neck; it varies from person to person.
Aftercare: What to Do and What to Avoid
✓ Do
- Keep the head elevated and use cold packs in the first days
- Keep scalp incisions clean and dry as advised
- Attend follow-ups and take medication as directed
- Protect healing skin from the sun
✕ Avoid
- Smoking and alcohol (impair wound healing)
- Heavy exercise, bending and straining for ~3–4 weeks
- Sauna and very hot showers early on
- Vigorous rubbing of the temples/cheeks early on
Back to Daily Life
- Sleep: Sleeping on your back with the head raised in the first days helps the swelling settle.
- Exercise: Light walking is fine from the first days; heavy exercise, bending and straining are usually postponed for 3–4 weeks.
- Hair care: Because the incisions are within the scalp, your surgeon will tell you when you can wash, colour and blow-dry your hair.
- Driving: When you can turn your head comfortably and painkillers no longer affect you.
- Flying: Usually after the stitches are removed and the first check-up.
- Sun: Protect the scars and healing skin from the sun in the first months.
- Back to work: Desk work usually after 7–10 days.
Timings vary with the person and any combined procedures; your surgeon sets the exact schedule.
Check-up Schedule and When to Call Immediately
The first check-up is usually in the first days and the stitches in the scalp come out around the first week; further check-ups are planned over the following weeks and months depending on how you heal. If you travel from elsewhere, remote follow-up and photo assessment are agreed in advance.
Call without waiting if you notice
- Rapidly increasing, firm swelling with growing pain on one side of the face or temple
- Bleeding that soaks the dressing and does not stop with pressure
- Skin around an incision turning dark purple, grey or black
- New or increasing weakness when raising the brow, closing the eye or smiling
- A sudden change in vision or rapidly increasing swelling around the eye
- A temperature of 38 °C or more, increasing redness or discharge at an incision
In an emergency such as difficulty breathing, chest pain or reduced consciousness, call 112 in Turkey (or your local emergency number) first, then let our team know.
Possible Risks and Safety
An endoscopic deep plane facelift is a planned operation and, like any surgery, carries risks; it is important to know them in advance:
- Swelling & bruising: expected around the midface/temples and settles within weeks.
- Temporary sensation/expression change: usually recovers; permanent nerve injury is rare.
- Hematoma: a blood collection that is drained if needed.
- Scar issues: the incisions stay within the scalp; rarely a visible scar or hair thinning along the incision can occur.
- Asymmetry: small side-to-side differences can occur; careful planning helps reduce this.
- Infection: rare; managed with sterile technique and follow-up.
A 2026 meta-analysis of deep plane facelifts (45 studies, 10,784 patients) found an overall complication rate of 6.6%; no permanent facial nerve injury was observed, and temporary nerve weakness was reported in 1.2%, haematoma in 1.8%, infection in 0.8% and skin necrosis in 0.1% (Koroma et al., 2026). Another review from 2025 comparing deep plane and SMAS techniques found patient satisfaction of 94.4% with the deep plane and 87.8% with the SMAS facelift (Khoury et al., 2025). These rates refer to the deep plane facelift performed through an incision around the ear; there are no large series for the combined endoscopic approach, and rates vary with technique and patient.
Quitting smoking helps reduce risk; blood thinners are adjusted with your doctor’s approval.
What an Endoscopic Deep Plane Facelift Can and Cannot Correct
What it can correct
- Descent of the midface (cheek) and cheek flattening
- Softening of the nose-to-mouth folds by lifting the cheek (the aim)
- A descended brow and temple
- Data on durability: in a series of 143 patients who had an endoscopic midface lift, a median 3.4 mm improvement in midface height was measured and the improvement was reported to last up to 15 years (Shtraks et al., 2019). It is a single-centre, retrospective study.
Its limits
- Neck and jawline sagging is not corrected by this technique; a deep plane facelift or neck lift is assessed separately
- Skin quality (fine wrinkles, pigmentation, sun damage) does not change with surgery; non-surgical treatment may be needed
- Marked volume loss may need fat injection
- The scientific data concern endoscopic midface lifts and deep plane facelifts separately; there are no large comparative studies of the two techniques used together
- Ageing continues; the result, healing and tissue response vary from person to person
What to Check When Choosing a Surgeon for an Endoscopic Deep Plane Facelift
Ask in which layer the lift will be done and about the surgeon’s experience in that layer.
Camera-assisted work needs specific training and equipment.
Ask in which hospital and with which anesthesia team the general anesthesia will be given.
Discuss at the consultation that the aim is a natural rather than a pulled look, and whether your expectations are realistic.
Expected Change (Medical Illustration)
The images in this section are not photos of real patients. The schematic below shows the typical change: a flat, dropped midface becomes a lifted, defined cheek with softer folds.
The illustrations are schematic drawings for information only. With any surgical or interventional procedure, results may vary from person to person. Please seek detailed advice from your doctor before any procedure. Personal results vary with anatomy, skin quality and technique and are not guaranteed.
Endoscopic Deep Plane Facelift in Istanbul: Examination, Surgery and Check-ups
Many patients travel to Istanbul for an endoscopic deep plane facelift; what matters most is the surgeon’s planning, where the operation takes place and the follow-up. The examination takes place at the practice in Ataşehir, and the operation in a hospital operating room (Memorial Göztepe Hospital).
The midface, brow, lower face and neck are assessed together; the technique is decided at the examination.
In a hospital operating room under general anesthesia; usually one night in hospital.
Your travel date is confirmed after stitch removal (around the first week) and the check-up.
Op. Dr. Ali Çetinkaya: Specialty and Professional Background
Specialist in Plastic, Reconstructive and Aesthetic Surgery (2017); working in plastic surgery since 2012, including specialty training. Member of TPRECD (Turkish Society of Plastic, Reconstructive and Aesthetic Surgeons), EPCD and ISAPS — member record. Biography: about me.
Preparing for Surgery
Skin quality, degree of midface descent, health and goals are assessed; the technique is chosen.
If possible, stop smoking weeks before surgery. Aspirin, blood thinners and some herbal products (omega-3, ginkgo) are stopped 7–10 days before, with your doctor’s approval; do not stop your regular medicines without asking your doctor.
Necessary blood tests and an anesthesia review are done.
Plan time off work and someone to help you in the first days.
Questions to Ask at Your First Consultation
To decide well, it helps to ask these at your pre-assessment:
- 1Is the endoscopic deep plane approach right for my face, or is another technique better?
- 2Where exactly will the incisions be?
- 3Should the lower face, neck or brow be addressed in the same session?
- 4What vertical lift can I realistically expect for my midface?
- 5How long will recovery take and when can I return to social life?
- 6What are the risks and the chance of temporary sensation/expression change?
- 7In which hospital and under what anesthesia will it be performed?
- 8How long can the effect be expected to last?
- 9How do I reach you if there is a problem?
For Patients Travelling From Abroad or Other Cities
If you are coming to Istanbul, the online pre-consultation, surgery, stitch removal, check-up and travel home are planned together. Because the stitches usually come out around the first week, a stay of at least about 7 days in Istanbul is advised; the exact length is set at the examination.
Front and side photos of your face or a video call give preliminary information; they do not replace a face-to-face examination.
The planned procedure, where the operation takes place, the type of anesthesia and what the fee includes are sent to you in writing.
Usually one night in hospital; the stitches are removed in Istanbul around the first week.
Plan your flight home after the surgeon’s check-up; agree in advance how remote follow-up will work and how to reach us if there is a problem.
Endoscopic Deep Plane Facelift Cost: What Determines the Price?
A firm price is given after examination, because scope, any added procedures (neck, brow, fat transfer) and clinic conditions vary per person. So you know what is included:
Usually included in the fee
- Surgeon, anesthesia and operating-room fee
- 1 night stay, dressing and medication
- Post-operative check-ups
If you see a very low price, ask in writing where the operation will take place, which anesthesia team will be involved and what is included.
Confirm in Writing Before Booking
- Who will perform the operation and who is on the surgical and anesthesia team
- The hospital where the operation takes place and the type of anesthesia
- The planned procedure(s) — midface, brow, lower face, neck, fat injection — and what is not included
- Hospital stay, post-operative check-ups and remote follow-up after you return home
- Medication and dressing materials
- What happens, and what it costs, if a complication needs further treatment or a revision is needed
- Transfer or accommodation — only if offered, and exactly what it covers
- Payment, deposit and cancellation terms
No prices or packages are published on this page; the fee is given after the examination, based on your individual plan.
Glossary
- Endoscope
- A fine camera that lets the surgeon operate through small incisions.
- Deep plane
- The layer beneath the SMAS where the retaining ligaments are released.
- SMAS
- The face’s support layer (muscle-fascia).
- Midface
- The cheek region between the eye and the mouth.
- Retaining ligaments
- Fibrous anchors that must be released for the tissue to move.
- Nasolabial fold
- The line from the side of the nose to the corner of the mouth.
Frequently Asked Questions
How is an endoscopic deep plane facelift different from a classic facelift?
Which areas does it treat best?
Where are the incisions and will there be scars?
How long does recovery take?
How long does the effect last?
Can it be combined with a neck lift or lower facelift?
How long does the surgery take and what anesthesia is used?
Am I too young/old for it?
Will my facial nerves be safe?
I’m coming from abroad — how does it work?
What is the difference between an endoscopic facelift and a deep plane facelift?
Does “endoscopic” mean a weaker lift?
Can fillers give the same result?
Videos
Explore our channels for video explanations and short-form content:
Medically reviewed by
Specialist in Aesthetic, Plastic and Reconstructive Surgery
- Specialist since 2017
- Member of TPRECD, EPCD and ISAPS
- Ataşehir, Istanbul
- Türkçe · English
Op. Dr. Ali Çetinkaya is a specialist in Plastic, Reconstructive and Aesthetic Surgery. Member of TPRECD (Turkish Society of Plastic, Reconstructive and Aesthetic Surgeons). He completed his residency in 2017 and practices at his private clinic in Ataşehir, Istanbul, specializing in deep plane facelift, neck lift, rhinoplasty, and eyelid surgery (blepharoplasty). He offers consultations in Turkish, English, and German for international patients.
Last updated:
This page is for information and does not replace medical advice.
Sources
- ASPS — Facelift
- TPRECD — Turkish Society of Plastic, Reconstructive and Aesthetic Surgeons
- Shtraks JP, Fundakowski C, Yu D, Hartstein ME, Sarcu D, Lu X, Wulc AE. Investigation of the Longevity of the Endoscopic Midface Lift. JAMA Facial Plast Surg 2019;21(6):535–541. doi:10.1001/jamafacial.2019.1015
- Koroma P, Reji N, Burridge I, et al. Deep Plane Facelifts: A Systematic Review and Meta-Analysis of Outcomes. Aesthetic Plast Surg 2026;50(17):6874–6896. doi:10.1007/s00266-026-06138-x
- Khoury S, Almubarak Z, Khan H, Boldt G, Villemure-Poliquin N, Nichols AC. The Deep Plane versus SMAS Facelift: A Systematic Review and Meta-Analysis. Aesthetic Plast Surg 2025;49(21):5895–5903. doi:10.1007/s00266-025-05118-x
