Technique: The incision run from the temple into the natural wrinkles in front of the ear, sometimes turning into the ear canal, rounding the earlobe going into the crease behind the ear, upwards and finally turning into the hairline. It is not necessary to cut or shave the hair.

The skin is then lifted and repositioned to leave the skin smoother and firmer. In cases of fat accumulation, it may be necessary to perform liposuction and a correction through a small incision under the chin. A firm dressing is applied for 24-48 hours.

COMPLICATIONS
There is a low risk of complications during and after surgery which are not due to the surgeon but more of a natural reaction that occurs in certain individuals. Patients will be carefully consulted and advised before this type of surgery.

Referred unwanted biologic events can occur with a certain low frequency and must be regarded as calculated risks. Other risks not mentioned can also occur. As a patient this must be considered before a decision for plastic surgery is set.

Bleeding: Postoperative bleeding can occur after every operation. If there is a significant bleeding the incision has to be opened again.. These risks are increased by the intake of painkillers containing Aspirin or Vitamin E. These medications should be avoided during the 2 weeks prior to operation. Smaller bleeds can cause bruising and minor scars in the subcutaneous tissues, which will feel like small lumps. These will gradually disappear.

Infection: All operations can cause infection, which will need antibiotic treatment.

Nerve Injury: The facial nerve and its branches run in the area but normally in a deeper level. The nerve to the frontal region crosses the zygomatic arch close to the periosteum, which will be elevated during an endoscopic lifting. The proximity increases the risk for damage. Even a totally cut nerve can regain its functions spontaneously after a couple of months.

Skin loss: If blood circulation is impaired (smoking, bleeding, infection, pressure) the blood supply to the thin, loosened skin can be disturbed and cause local necrosis.

Scars: Scars are normally very discrete. Even in persons with a tendency to get hypertrophic scarring on other parts of the body, usually get discreet scarring in the face. The scars behind the ears have a tendency to get somewhat elevated in the beginning. All scars are red for 3-4 months and bleaches gradually. The scars should be protected against sunlight and solarium for half a year.

Hair loss: Hair bearing skin that is elevated will usually have transient thinning of the hair growth. The hairlines are pulled up, backwards according to the stretching of the skin. This is unavoidable.

Smoking: Smoking depravities the blood circulation and has a negative impact on the wound healing. Smoking should therefore be avoided at least 2 weeks prior to the planned procedure and during the healing phase.