Direct Vision Endomidface is an innovative facelift technique that offers natural and lasting results with minimal invasion. In this complete guide, you will discover everything about this revolutionary procedure, from its benefits and indications to the step-by-step technique and post-operative care.
Created by renowned plastic surgeon Dr. Robério Brandão, the Direct Vision Endomidface technique represents an evolution in facial surgery, combining the principles of deep plane lifting with the precision of direct vision and minimization of scars.
[Image: Dr. Robério Brandão in operating room performing Direct Vision Endomidface]
What is Direct Vision Endomidface?
Direct Vision Endomidface is a surgical procedure aimed at rejuvenating the midface, the region of cheeks and cheekbones. Unlike traditional techniques, Endomidface is performed through a small incision in the temporal region, inside the hairline, which guarantees a result with practically invisible scars.
The great innovation of this technique is the use of direct vision, without the need for an endoscope. This allows the surgeon to have a clearer and more precise view of facial structures, as well as more precise control of movements, resulting in a safer and more effective procedure.
According to Dr. Robério Brandão, creator of the technique and the Modern Face philosophy, “Direct Vision Endomidface is the key to natural and lasting facial rejuvenation, with minimal invasion and maximum safety”.
Main Features of Direct Vision Endomidface:
- Minimal incision: A small incision in the temporal region, inside the hairline, makes scars practically imperceptible.
- Direct vision: The technique dispenses with the use of an endoscope, allowing the surgeon to have a clearer and more precise view of facial structures.
- Deep plane: Endomidface acts on the sub-SMAS (Superficial Musculoaponeurotic System) plane, repositioning tissues more naturally and permanently.
- Rapid recovery: The minimally invasive technique allows faster and more comfortable recovery, with return to social activities in about 7 days.
- Natural results: Endomidface promotes facial rejuvenation with subtle and harmonious results, preserving the patient’s identity and expressiveness.
- Safety: Precise technique and preservation of important structures, such as nerves and blood vessels, minimize risks of complications.
[Image: Visual comparison between traditional access and Direct Vision Endomidface access, highlighting smaller incision and preservation of structures]
Who is Direct Vision Endomidface indicated for?
Direct Vision Endomidface is indicated for patients who present:
- Moderate laxity of the midface.
- Sagging cheeks and loss of malar projection.
- Accentuation of nasolabial fold (smile lines).
- Vertically elongated lower eyelid.
- Loss of jaw definition.
- Desire for natural and lasting facial rejuvenation.
- Expectation of rapid recovery and minimal scars.
- History of facial fillers or biostimulators.
It is important to emphasize that Endomidface indication must be evaluated individually by a qualified plastic surgeon, who will analyze the patient’s facial characteristics, expectations, and goals.
[Infographic: List of Endomidface indications with illustrative icons]
Benefits of Direct Vision Endomidface
The Direct Vision Endomidface technique offers a series of benefits over traditional facelift techniques, including:
- Natural and lasting results: Repositioning tissues in the sub-SMAS plane promotes facial rejuvenation with subtle and harmonious results that are maintained for many years.
- Minimal scars: The small incision in the temporal region makes scars practically imperceptible, allowing the patient to return to their routine without visible signs of surgery.
- Rapid recovery: The minimally invasive technique allows faster and more comfortable recovery, with return to social activities in about 7 days.
- Lower risk of complications: Precise technique and preservation of important structures, such as nerves and blood vessels, minimize risks of complications, such as nerve injuries and hematomas.
- Personalized approach: Endomidface can be combined with other surgical procedures, such as blepharoplasty and neck lift, for complete and personalized facial rejuvenation.
- Correction of laxity: The technique lifts facial tissues precisely, favoring improvement in verticality and projection of the malar region.
- Contour improvement: The technique promotes significant improvement in midface contour, defining cheekbones and smoothing the nasolabial fold.
- Rejuvenation with minimal scars: Incisions are small and strategically planned, resulting in practically imperceptible scars.
- Lasting results: Improvements provided by Endomidface can be maintained for up to 15 years in some cases.
- Rapid recovery: Recovery time is reduced compared to traditional facelift, allowing patients to resume daily activities more quickly.
CTA: Want to know if Endomidface is the ideal solution for you? Schedule a consultation with Dr. Robério Brandão and discover how to rejuvenate your face naturally and safely. [Link to schedule consultation]
How is Direct Vision Endomidface performed?
Endomidface surgery is performed in a hospital environment, under local anesthesia with sedation. The procedure lasts on average 2 to 3 hours and follows these steps:
- Marking: The surgeon performs markings on the patient’s face, delimiting areas to be treated and incision location.
- Anesthesia: Local anesthesia with sedation is applied to ensure patient comfort during the procedure.
- Incision: A small incision is made in the temporal region, inside the hairline.
- Dissection: The surgeon dissects facial tissues in the sub-SMAS plane, using delicate and precise instruments.
- Repositioning: Facial tissues are repositioned and fixed in a new position, using internal sutures.
- Closure: The incision is closed with sutures, and a compressive dressing is placed.
[Video: 3D animation showing step-by-step of Direct Vision Endomidface]
Post-Operative Recovery
Recovery after Direct Vision Endomidface is generally fast and comfortable. In the first few days, it is common for the patient to present swelling and bruising on the face, which tend to decrease gradually.
Recommendations for successful recovery:
- Rest relative in the first few days.
- Application of cold compresses on face to reduce swelling.
- Use of painkillers to relieve pain.
- Avoid sun exposure and intense physical activities for at least 30 days.
- Follow medical instructions to ensure proper healing.
[Image: Patient in different recovery phases after Direct Vision Endomidface]
Risks and Complications
Like any surgical procedure, Direct Vision Endomidface presents some potential risks and complications, such as:
- Hematoma.
- Infection.
- Facial nerve injury.
- Facial asymmetry.
- Hypertrophic scars or keloids.
- Skin necrosis.
However, these risks are minimized due to precise technique and preservation of important structures, such as nerves and blood vessels. Additionally, choosing a qualified and experienced plastic surgeon is fundamental to reduce risks and ensure satisfactory result.
According to data from Dr. Robério Brandão, in over 212 cases of Direct Vision Endomidface, the complication rate was less than 3%, and there was no record of permanent nerve injury.
Endomidface vs Deep Plane: What is the difference?
Both Endomidface and Deep Plane are facelift techniques that act on the sub-SMAS plane, providing lasting and natural results. However, there are some important differences between the two procedures:
| Feature | Direct Vision Endomidface | Deep Plane Facelift |
|---|---|---|
| Incision | Small temporal incision | Incision around the ear |
| Vision | Direct vision | Endoscopic |
| Dissection | Limited to midface | Broader, including lower third |
| Recovery | Faster | Slower |
| Risks | Lower | Potentially higher |
| Jowls | Does not correct | Corrects |
In summary, Endomidface is a less invasive technique, with faster recovery and lower risk of complications, ideal for patients with moderate midface laxity. Deep Plane is a more comprehensive technique, which can also correct lower face laxity, but with a longer recovery time and higher risk of complications.
The choice between Endomidface and Deep Plane should be made together with the plastic surgeon, taking into account the patient’s facial characteristics, expectations, and goals.
[Comparative Table between Endomidface and Deep Plane]
Endomidface and Modern Face Philosophy
Direct Vision Endomidface is one of the techniques that make up the Modern Face philosophy, an innovative concept that seeks to offer complete, natural, and lasting facial rejuvenation, with minimal invasion and maximum safety.
Pillars of Modern Face Philosophy:
- Non-Negotiable Safety: Maximum priority in preserving important structures, such as nerves and blood vessels.
- Elegance in Simplicity: Search for natural and harmonious results, with precise and minimally invasive techniques.
- Optimized Recovery: Emphasis on rapid and comfortable post-operative, with return to social activities in a few days.
- Structural results: Promote facial rejuvenation through repositioning of deep tissues, not just skin.
Direct Vision Endomidface represents the materialization of these pillars, offering a safe, effective, and minimally invasive alternative for midface rejuvenation.
[Image: Modern Face logo with three pillars: Safety, Elegance, Results]
Relevant Anatomy for This Procedure
Anatomical knowledge is fundamental to understand how results are achieved safely and effectively.
Key Structures
The face is composed of layers that must be understood together:
- Skin: most superficial layer, reflecting aging through wrinkles and laxity
- Subcutaneous tissue: contains fat that redistributes with age
- SMAS (Superficial Musculoaponeurotic System): fundamental layer connecting muscles to skin
- Facial muscles: responsible for expression and dynamic support
- Retaining ligaments: anchor skin to facial skeleton
- Facial nerves: control movement and sensitivity
Surgical Planes
In Modern Face philosophy, we work in specific planes:
- Superficial plane: above SMAS, used in less invasive procedures
- Deep plane (sub-SMAS): below SMAS, allows more lasting results
- Subcutaneous plane: utilized for fat grafting and fat treatment
Why This Matters
Understanding anatomy explains:
- Why certain procedures last longer than others
- How natural results are achieved
- Why surgeon experience is crucial
- How complications can be avoided
“Respect for anatomy is what separates a natural result from an artificial one. In Modern Face, each structure has its role and must be preserved or repositioned with precision.” — Dr. Robério Brandão
Conclusion
Direct Vision Endomidface is a revolutionary technique that offers natural and lasting facial rejuvenation with minimal invasion. If you seek to rejuvenate your face safely and effectively, Endomidface may be the ideal solution for you.
Schedule a consultation with Dr. Robério Brandão and discover how Direct Vision Endomidface can transform your face and self-esteem.
CTA: Schedule your consultation with Dr. Robério Brandão and discover how to rejuvenate your face naturally and safely. [Link to schedule consultation]
Related Content
- Endomidface vs Deep Plane: Which is the best option for you?
- Modern Face: The concept behind natural rejuvenation
- Facelift: Complete guide to lasting rejuvenation
FAQ (Frequently Asked Questions)
What is Direct Vision Endomidface?
It is a midface lift technique performed through a small temporal incision, without the need for an endoscope.
What are the benefits of Endomidface?
Natural results, rapid recovery, minimal scars, and lower risk of complications.
Is Endomidface right for me?
It is ideal for patients with moderate midface laxity, sagging cheeks, and loss of malar projection.
How is recovery after Endomidface?
Recovery is generally fast, with return to social activities in about 7 days.
What are the risks of Endomidface?
Risks are minimized due to precise technique and preservation of important structures, such as nerves and blood vessels.
Does Endomidface correct jowls?
No, Endomidface does not correct jowls. For this region, it is necessary to combine with other techniques, such as Deep Neck.
What is the difference between Endomidface and Deep Plane?
Endomidface accesses the deep plane through the mobile SMAS, bypassing fibrosis caused by biostimulators, while traditional Deep Plane traverses this area.
⚠️ Disclaimer
This content is educational and represents the author’s technical opinion based on documented clinical experience. Surgical decisions should be individualized.
Author: Dr. Robério Brandão, CRM-CE 8596 Last update: January 2026