Dr. Robério Brandão

In 2006, Dr. Robério Brandão began developing what would become the ENDOMIDFACE® by Direct Vision technique — not out of academic curiosity, but out of clinical necessity.

Working in Natal, Rio Grande do Norte, Brazil, Dr. Brandão faced a practical reality that many surgeons outside major metropolitan centers understand: expensive endoscopic equipment wasn't accessible. The $100,000-$150,000 towers that enabled traditional endoscopic midface surgery were simply not available.

But patients still needed facial rejuvenation. The midface — the area between the lower eyelid and the mouth — was sagging. Traditional SMAS techniques couldn't adequately address this region. And waiting for equipment that might never arrive wasn't an option.

"I didn't set out to create a new technique. I set out to solve a problem: how to safely lift the midface without equipment I didn't have."

The 2007 Breakthrough: Proving Direct Vision Was Possible

In 2007, Dr. Brandão became a pioneer in facial videoendoscopy in Rio Grande do Norte. But paradoxically, this experience with endoscopic surgery revealed its limitations — and pointed toward a better path.

The endoscope showed what needed to be done. But did you really need a camera to do it? Dr. Brandão's insight was radical: with proper incision placement, adequate lighting, and meticulous anatomical knowledge, you could achieve the same — or better — visualization with direct vision.

This wasn't a step backward. It was a step forward: eliminating expensive equipment, reducing potential points of failure, and giving the surgeon more control, not less.

The Modern Challenge: Faces Changed by Bioestimulators

By the 2010s, a new challenge emerged that validated Dr. Brandão's approach. Facial fillers and bioestimulators became ubiquitous. Most patients seeking facial surgery today have previously received injectable treatments.

These treatments change the surgical landscape — literally. The planes that traditional techniques rely upon are no longer predictable. Fibrotic tissue creates adhesions. Granulomas hide in unexpected locations. The "classic" face is now the exception, not the rule.

This is where the Modern Face® philosophy becomes essential. Dr. Brandão recognized that surgical approaches designed for virgin tissue needed to evolve for the contemporary patient — and ENDOMIDFACE® by Direct Vision was already adapted for this reality.

The Safety Record: More than 1,000 Facial Surgeries Without Any Irreversible Motor Nerve Injury

Perhaps the most compelling evidence for any surgical technique is its safety record. Over 18 years, Dr. Brandão has documented more than 1,000 facial surgeries without any irreversible motor nerve injury.

This isn't marketing language. This is documented clinical data. The complete case series safety analysis is available for review by medical professionals.

The safety comes from the technique itself: Direct Vision means you see the anatomical structures you need to protect. There's no camera delay. No parallax error. No equipment malfunction. Just your eyes, your hands, and your knowledge of anatomy.