What is endoscopic facial surgery?
It is the application to the face of the same principle that transformed general surgery three decades ago: instead of opening in order to see, a camera is introduced. Through three to five incisions of roughly two centimetres, hidden inside the scalp, an endoscope is inserted that projects the deep anatomy —muscle, nerve, periosteum— magnified onto a monitor, and the work is done with long, fine instruments under direct vision.
The contrast with the classic technique is the whole point of the procedure. The traditional (coronal) brow lift requires an incision from ear to ear over the top of the head, with everything that entails: a long scar, numbness of the scalp behind the incision, backward displacement of the hairline and a considerable recovery. The endoscopic route achieves the same goals —raising the brows, correcting a descended forehead, weakening the muscles that produce glabellar frown lines— without that incision.
What is corrected by this route
- Descended brows (lateral brow ptosis): the sign that makes a gaze read as tired, angry or sad even when the person is not. Raising the tail of the brow by a few millimetres changes the expression of the whole face.
- A descended forehead and a "heavy" upper eyelid: frequently what a patient identifies as excess eyelid skin is in fact a brow that has dropped and is pushing the skin downward. Operating on the eyelid without correcting the brow in those cases leaves the problem unsolved — and sometimes makes it worse. That is one reason the upper third is assessed together with blepharoplasty, not separately.
- Glabellar and forehead lines: the muscles that produce them (corrugator, procerus) are reached directly and weakened surgically and durably — not every few months.
- Brow asymmetry: corrected by elevating each side independently.
Dr. Arístides Arellano’s track record in endoscopic surgery
This is not a technique added to the catalogue as a fashion. Dr. Arístides Arellano trained in it as endoscopy was entering plastic surgery, and he was invited to teach it. All the documents are in his credential archive:
- Endo-Facial / Body Training Seminar — training in endoscopic surgery (1994).
- Invited speaker: “Endoscopic surgery in plastic surgery” — 31st Congress, International College of Surgeons, Mexico Section (Tlaxcala, 1994).
- Endoscopic Surgery Society of Hospital Betania, Puebla (1995) and the 4th Surgery Congress of the same society (1995).
- Invited speaker: “Endoscopic facial plastic surgery” — Mexican Academy of Surgery, Eastern Chapter (Puebla, 1997).
- Lecturer: “Plastic surgery by endoscopic method” — Apizaco Medical Association (Tlaxcala, 1997).
How is it performed?
It is performed under general anaesthesia or deep sedation in a hospital operating room. It lasts approximately 1.5 to 3 hours. The incisions are made inside the scalp, behind the hairline, so no visible scar remains. The forehead tissues are released from the bone under endoscopic vision, repositioned upward and fixed at their new height. It is usually outpatient or a short stay.
All surgery carries risk and requires a prior medical assessment. Results may vary according to each patient, their anatomy and their individual healing process.
Who is a good candidate?
- Descended brows, a tired gaze, or a permanently stern or angry expression caused by brow position.
- Marked glabellar or forehead lines that no longer respond well to temporary treatments.
- Patients considering a blepharoplasty whose assessment reveals that the eyelid "excess skin" actually comes from a descended brow.
- A scalp with enough hair to conceal the incisions. In patients with advanced baldness or a very high forehead, the endoscopic route loses its main advantage and other options are assessed — and that is said plainly at the consultation.
- Good general health and realistic expectations.
Recommended post-surgical treatments
Dr. Arístides may recommend facial manual lymphatic drainage and hyperbaric chamber sessions to reduce swelling of the forehead and eyelids, which is noticeable in the first days. See the full guide: Post-surgical recovery and care.
Before and after
Most patients want to see before-and-after photographs before deciding. Out of respect for each person’s privacy, Dr. Arístides Arellano shows real cases —always with documented consent— during your in-person consultation, where you can review results from patients with a starting point similar to yours. Results may vary from patient to patient.
Approximate price
Endoscopic facial surgery has no line of its own on the 2025 price list, and we are not going to invent one. The cost depends on the extent of the procedure and on whether it is combined with blepharoplasty or a facelift in the same operation —which is usually more efficient than operating separately— plus hospital and anaesthetist fees. It is defined at the consultation, with a clear written quote. See the other references in the price list.
About Dr. Arístides Arellano
Dr. Arístides Arellano is a plastic surgeon holding a specialty licence: he practises under a Mexican medical licence (D.G.P. 1125959) and a specialty licence in Plastic & Reconstructive Surgery (0002008), both issued by the Directorate General of Professions (DGP), which reissued his certificate of professional standing in 2025. His career began before Mexico’s present-day specialty-board system existed: he belongs to the founding generation of plastic surgery in Puebla, the second generation of a surgical tradition started in 1971 by Dr. Francisco Arellano Ocampo. Trust is verified, not promised: both licences are public and anyone can look them up in the DGP’s National Registry of Professionals.
Related patient guide
If your question is about the eyelids and the gaze: Blepharoplasty: at what age, and how long results last — part of the informational guide series reviewed by Dr. Arístides Arellano.
Recovery · step by step
- Days 1–7Swelling of the forehead and eyelids, more noticeable than patients anticipate. Rest with the head elevated.
- Week 2Visible swelling subsides; most resume social life. Scalp numbness may be present.
- Weeks 3–6Progressive return to exercise. Numbness resolves gradually.
- Months 1–6The definitive brow position settles and the expression normalises.
Frequently asked questions
What is endoscopic facial surgery?
It is surgery of the upper third of the face —forehead, brows, glabella— performed with an endoscope: a camera introduced through three to five incisions of about two centimetres hidden inside the scalp, projecting the deep anatomy magnified onto a monitor. It allows the brows to be raised, a descended forehead corrected and the glabellar muscles weakened, without the ear-to-ear incision the classic coronal technique requires.
How much does endoscopic facial surgery cost in Puebla?
It has no line of its own on the 2025 price list and we do not invent one. The cost depends on the extent of the procedure, on whether it is combined with blepharoplasty or a facelift in the same operation, and on hospital and anaesthetist fees. It is defined at the consultation, with a clear written quote.
Does an endoscopic brow lift leave a scar?
The incisions are made inside the scalp, behind the hairline, and measure about two centimetres, so no visible scar remains. That is its main advantage over the classic coronal lift, which requires an ear-to-ear incision over the top of the head.
Do I need a blepharoplasty or a brow lift?
It is one of the most useful questions about the upper third. Frequently what the patient identifies as excess eyelid skin is in fact a brow that has descended and is pushing the skin down. Operating on the eyelid without correcting the brow in those cases leaves the problem unsolved, and sometimes makes it worse. That is why the upper third is assessed as a whole and not piece by piece.
Does an endoscopic brow lift replace botulinum toxin?
They are different things. Endoscopic surgery reaches the muscles that produce glabellar lines directly and weakens them surgically and durably, and it also repositions the brow, which an injectable does not do in the same way or with the same permanence. The indication for each is defined at the assessment.
Can I have it if I have thin hair or a receding hairline?
The endoscopic route depends on there being scalp with enough hair to conceal the incisions. In patients with advanced baldness or a very high forehead, that advantage is lost and other options should be assessed. You will be told plainly at the consultation rather than offered a technique that does not suit you.
What is Dr. Arístides Arellano’s experience in endoscopic surgery?
He trained at the Endo-Facial / Body Training Seminar in endoscopic surgery in 1994 and was an invited speaker on endoscopic surgery in plastic surgery at the 31st Congress of the International College of Surgeons, Mexico Section, the same year. In 1997 he was an invited speaker on endoscopic facial plastic surgery at the Mexican Academy of Surgery, Eastern Chapter, and a lecturer on plastic surgery by endoscopic method at the Apizaco Medical Association. He belonged to the Endoscopic Surgery Society of Hospital Betania in Puebla from 1995. The documents are in the credentials section of this site.
How long does the result last?
The repositioning of the forehead and brows is durable, but it does not stop ageing: tissues continue their course from a better starting point. Results may vary according to each patient and over time.
Every case is different. Discuss yours in a personal consultation.
Book a consultation on WhatsAppEvery figure published on this site is approximate and is not a quote. Any procedure or treatment first requires a private assessment consultation with Dr. Arístides Arellano —$800 MXN, charged separately— and it is at that consultation that the definitive cost of your case is determined.
Educational content; it does not replace a medical consultation. Results may vary from person to person.