Endoscopic Surgery

“The ‘short cut’ to less scars and faster healing.”

Endoscopic surgery or endoscopy is a surgical technique that involves the use of an endoscope, a special viewing instrument that allows a surgeon to see images of the body's internal structures through very small incisions. Endoscopic surgery has been used for decades in a number of different procedures, including gallbladder removal, tubal ligation, and knee surgery.

An endoscope consists of two basic parts: A tubular probe fitted with a tiny camera and bright light, which is inserted through a small incision; and a viewing screen, which magnifies the transmitted images of the body's internal structures. During surgery, Dr. Guy watches the screen while moving the tube of the endoscope through the surgical area.

It's important to understand that the endoscope functions as a viewing device only. To perform the surgery, a separate surgical instrument--such as a scalpel, scissors, or forceps--must be inserted through a different point of entry and manipulated within the tissue. However, with endoscopic surgery, your scars are likely to be hidden, smaller and some of the after effects of surgery may be minimized.

In a typical endoscopic procedure, only a few small incisions, most less than one inch long, are needed to insert the endoscope probe and other instruments. For some procedures, such as breast augmentation, only two incisions may be necessary. For others, such as a forehead lift, three or more short incisions may be needed. The tiny "eye" of the endoscope's camera allows a surgeon to view the surgical site almost clearly as if the skin were opened from a long incision.

Because the incisions are shorter with endoscopy, the risk of sensory loss from nerve damage is decreased. Also, bleeding, bruising and swelling may be significantly reduced. With the endoscopic approach, you may recover more quickly and return to work earlier than if you had undergone open surgery. Many endoscopic procedures can be performed on an outpatient basis.

Consultation & Preparation

Keep in mind that endoscopic surgery requires a skilled, specially trained surgeon. Dr. Guy is a board-certified plastic surgeon with general and plastic surgery training in endoscopy and is continually trained in new procedures. She will determine if endoscopic surgery is an option for your desired procedure.

Patients who tend to be the best candidates for cosmetic endoscopic procedures are those who don't have large amounts of loose hanging skin. Patients with loose facial or abdominal skin may benefit from a combination of classic open and endoscopic techniques, in face or forehead lift, or abdominoplasty.

Dr. Guy will also give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, not smoking, and taking or avoiding certain vitamins, and medications.

If you smoke, plan to quit at least one to two weeks before your surgery and not to resume for at least two weeks after your surgery. Avoid overexposure to the sun before surgery and do not go on a stringent diet, as both can inhibit your ability to heal. If you develop a cold or infection of any kind, your surgery will probably be postponed.

Many endoscopic procedures do not require a hospital stay and are performed in an out-patient surgery center. Whether your surgery is done in a surgical center or a hospital, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two after you leave the
facility, if needed.

The Plastic Surgery

The use of endoscopy in plastic surgery keeps growing. Some of the more common procedures today include:

Tummy tucks – Endoscopy is sometimes used as an adjunct for selected patients who have lost abdominal muscle tone. Guided by the endoscope, the muscles that run vertically down the length of the abdomen may be tightened through several short incisions.

Breast augmentation – Inserted through a small incision in the underarm or the navel, an endoscope can assist the physician in positioning breast implants within the chest wall. Endoscopy may also assist in the correction of capsular contracture (scar tissue that sometimes forms around an implant, causing it to feel firm), and in the evaluation of existing implants.

Facelift – Certain selected individuals may benefit from an endoscopically assisted procedure. When an endoscope is used, the customary incision along, or in the hairline is usually eliminated. Instead, small incisions may be strategically placed in areas where the most correction is needed. If the muscles and skin of the mid-face need to be smoothed and tightened, incisions may be hidden in the lower eyelid and in the upper gumline. To tighten the loose muscles of the neck, incisions may be concealed beneath the chin and behind the ears. The endoscope may also assist in the positioning of cheek and chin implants.

Forehead lift – Of all the cosmetic procedures that use endoscopy, forehead lift is the one which plastic surgeons more commonly perform. Instead of the usual ear-to-ear incision, three or more "puncture-type" incisions are made just at the hairline. The endoscope helps guide Dr. Guy, who removes the muscles that produce frown lines, and repositions the eyebrows at a higher level.

For Reconstructive surgery, Endoscopy can assist in repairing body parts that are damaged from injury or illness. Some of these procedures are Flap
surgery, Placement of tissue expanders, Sinus surgery and Carpal tunnel release surgery.

Recovery & Results

In some cases, endoscopic surgery may require less recovery time than is usually required for open procedures. It will vary depending on the plastic surgery procedure, your health and physical condition. Dr. Guy will give you instructions for showering and changing your dressings.