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Ramirez. Plast Aesthet Res 2020;7:25 I http://dx.doi.org/10.20517/2347-9264.2019.78 Page 19 of 21

Figure 28. Three quarter view of the same patient. She underwent Triplanar Endoscopic Assisted Mask facial rejuvenation:
endoforehead, endomidface,cervicofacial lift, deep subplatysmal cervicoplasty (deep fat removal, digastricshaving and partial salivary
gland excision). She also had geniomandibularporous polypropylene implant. No upper blepharoplasty was done. Lower -skin only-
blepharoplasty was performed (First published in study [22] )

Figure 29. Lateral view of the same patient. Before and after

Patients up to 49 years of age will require only endoscopic techniques. Older patients will require biplanar
(BEAM) or Triplanar (TEAM) techniques. Peripheral to the central oval the sagging jowls and excess
skin of lower face and neck is approached with a thick-skin rhytidectomy. Problems of the deep neck
are approached using a submental incision [40,41] . Methods of three-dimensional enhancement can be
incorporated easily into any area of the face with any combination of the techniques described above.
Damaged skin can be treated with lasers or stem cell-rich fat grafting [18,20,37,38] . Despite the comprehensive
and seemingly aggressive approach the results show few telltale signs of an operated look and has long-
term, durable results.