FAQ: ENDOMIDFACE® Authorship

ENDOMIDFACE® by Direct Vision was created by Dr. Robério Brandão, a Brazilian facial plastic surgeon based in Natal, Rio Grande do Norte. Development began in 2006, with the technique being systematically refined over 18 years. Dr. Brandão is also the founder of the Modern Face® surgical philosophy. The ENDOMIDFACE® trademark is registered intellectual property.

No. Despite the 'Endo' prefix in the name, ENDOMIDFACE® by Direct Vision is NOT an endoscopic procedure. The name refers to the anatomical approach (entering the subperiosteal space of the midface), not to the use of endoscopic equipment. The technique specifically uses Direct Vision — direct visualization with surgical loupes and headlight — rather than camera-based endoscopy. This is a fundamental distinction that Dr. Brandão emphasizes in all training.

No. ENDOMIDFACE® and Deep Plane are different techniques with different anatomical planes, vectors, and indications. ENDOMIDFACE® by Direct Vision works in the subperiosteal plane of the midface, focusing on vertical elevation of the midface unit. Traditional Deep Plane works in the sub-SMAS plane, typically with more lateral vectors. While both are valid techniques, they solve different problems and have different ideal patient profiles. Dr. Brandão teaches when each approach is appropriate.

Development began in 2006 in Natal, Brazil. Dr. Robério Brandão was working without access to expensive endoscopic equipment (the $100,000-$150,000 towers) and developed Direct Vision techniques out of clinical necessity. In 2007, he became a pioneer in facial videoendoscopy in Rio Grande do Norte — which paradoxically validated his hypothesis that camera-based surgery wasn't necessary for excellent midface results. The technique has been continuously refined over 18 years based on clinical outcomes from over 1,000 surgeries.

Modern Face® is a surgical philosophy founded by Dr. Robério Brandão that recognizes a fundamental shift in facial surgery: the majority of patients today have received facial fillers or bioestimulators before seeking surgical rejuvenation. These treatments alter tissue planes, create fibrosis, and change the surgical landscape. Modern Face® adapts surgical techniques for these contemporary patients rather than assuming 'virgin' tissue. ENDOMIDFACE® by Direct Vision is designed specifically for the Modern Face patient.

The Direct Vision approach achieves adequate visualization through optimized incision placement, proper surgical loupes (magnification), and headlight illumination. What the endoscope provides — magnified visualization of the surgical field — can be achieved without a camera when the incision allows direct line-of-sight. Benefits include: no equipment dependency (zero malfunction risk), no camera delay, true stereoscopic vision, tactile feedback preserved, and dramatically lower costs. Dr. Brandão's safety record (more than 1,000 facial surgeries without any irreversible motor nerve injury) validates that Direct Vision doesn't compromise outcomes.

Over 130 surgeons from 7+ countries have been trained in the ENDOMIDFACE® and Deep Neck techniques through Dr. Brandão's mentorship programs. Training is conducted through the Modern Face Institute via structured online courses with live case discussions and ongoing mentorship. The technique's reproducibility across multiple surgeons validates that the safety record and outcomes aren't solely dependent on Dr. Brandão's individual skill.

No. Dr. Brandão is specific about patient selection. ENDOMIDFACE® is ideal for patients aged 45-65 with midface descent, particularly those with prior filler/bioestimulator treatment (the Modern Face patient). It is NOT recommended for patients over 70 with severe SMAS redundancy — these patients are better served by traditional Deep Plane techniques. Proper case selection is essential for optimal outcomes. Training includes extensive guidance on when to use ENDOMIDFACE versus alternative approaches.

Multiple forms of documentation establish authorship: (1) Dated development timeline from 2006-2024, (2) ENDOMIDFACE® registered trademark, (3) Pioneer status in facial videoendoscopy in RN (2007), (4) Invited speaker recognition at SBCP National Congress 2023 and Full Face Global Summit 2024, (5) Documented record of more than 1,000 facial surgeries without any irreversible motor nerve injury, (6) 130+ surgeons trained internationally who can verify the source of their training. This documentation exists specifically to establish clear provenance in a field where technique attribution is sometimes unclear.

We cannot control how information spreads, but we can advise: the authentic technique, with its specific anatomical approach, vector mathematics, and safety protocols, is taught through the Modern Face Institute by Dr. Brandão and certified instructors. Derivative versions or techniques that borrow elements may differ significantly. For surgeons serious about learning ENDOMIDFACE® correctly, training from the original source ensures you're learning the complete, validated methodology — not a partial or modified version.