{"title":"22年的小切口垂直内窥镜提升:内窥镜面部年轻化之旅。","authors":"Alessandro Gennai, Mattia Colli, Leonardo Gaggio","doi":"10.3389/fsurg.2025.1634862","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The Minimal Incision Vertical Endoscopic Lifting (MIVEL) is a minimally invasive facial rejuvenation technique that repositions tissues with minimal scarring, reduced recovery time, and long-lasting results, while achieving a natural appearance. This study aims to describe the updated MIVEL procedure, focusing on its evolution over 22 years and providing methodological details. This includes refining the indications, identifying key fixation points for reproducible results, and highlighting the long-term success of MIVEL as an effective approach for facial rejuvenation with minimal scarring and reduced complications.</p><p><strong>Methods: </strong>This retrospective analysis encompasses a comprehensive review of 784 patients who underwent MIVEL between 2001 and 2023. The MIVEL technique involves small incisions, endoscopic guidance, and vertical lifting to reposition facial tissues. Preoperative and postoperative photographs, patients' demographic data, and complication rates were analyzed. Included patients were those seeking facial rejuvenation without extensive skin excision and attending all follow-up visits up to at least one year postoperatively. Patients were categorized into three MIVEL groups (I, II, III) of dissection, based on their age and related aging signs.</p><p><strong>Results: </strong>The average age of patients was 50.5 years, with the majority falling in the MIVEL II group (53.1 years). MIVEL I was primarily performed on younger patients (21-35 years), while MIVEL III was reserved for those over 55 years. Adjunctive procedures, such as guided Superficial Enhanced Fat Fluid Injection (SEFFI), blepharoplasty, and neck lift, were commonly combined with the MIVEL procedure. The complication rates were low, with transient issues like neuropraxia and periocular ecchymosis being the most common. No cases of severe complications like skin necrosis or permanent nerve injury were reported.</p><p><strong>Discussion: </strong>MIVEL has proven to be a highly effective and well-tolerated technique for the rejuvenation of the upper and middle thirds of the face. Its minimally invasive nature reduces recovery times and minimal scarring while providing lasting and natural-looking results. The 22-year experience underscores the reliability and high patient satisfaction associated with MIVEL, making it a preferred choice for facial rejuvenation surgery. Future directions include further refining the technique and exploring its applicability to other facial and neck rejuvenation areas.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1634862"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497704/pdf/","citationCount":"0","resultStr":"{\"title\":\"22 years of Minimal Incision Vertical Endoscopic Lift: a journey in endoscopic facial rejuvenation.\",\"authors\":\"Alessandro Gennai, Mattia Colli, Leonardo Gaggio\",\"doi\":\"10.3389/fsurg.2025.1634862\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The Minimal Incision Vertical Endoscopic Lifting (MIVEL) is a minimally invasive facial rejuvenation technique that repositions tissues with minimal scarring, reduced recovery time, and long-lasting results, while achieving a natural appearance. This study aims to describe the updated MIVEL procedure, focusing on its evolution over 22 years and providing methodological details. This includes refining the indications, identifying key fixation points for reproducible results, and highlighting the long-term success of MIVEL as an effective approach for facial rejuvenation with minimal scarring and reduced complications.</p><p><strong>Methods: </strong>This retrospective analysis encompasses a comprehensive review of 784 patients who underwent MIVEL between 2001 and 2023. The MIVEL technique involves small incisions, endoscopic guidance, and vertical lifting to reposition facial tissues. Preoperative and postoperative photographs, patients' demographic data, and complication rates were analyzed. Included patients were those seeking facial rejuvenation without extensive skin excision and attending all follow-up visits up to at least one year postoperatively. Patients were categorized into three MIVEL groups (I, II, III) of dissection, based on their age and related aging signs.</p><p><strong>Results: </strong>The average age of patients was 50.5 years, with the majority falling in the MIVEL II group (53.1 years). MIVEL I was primarily performed on younger patients (21-35 years), while MIVEL III was reserved for those over 55 years. Adjunctive procedures, such as guided Superficial Enhanced Fat Fluid Injection (SEFFI), blepharoplasty, and neck lift, were commonly combined with the MIVEL procedure. The complication rates were low, with transient issues like neuropraxia and periocular ecchymosis being the most common. No cases of severe complications like skin necrosis or permanent nerve injury were reported.</p><p><strong>Discussion: </strong>MIVEL has proven to be a highly effective and well-tolerated technique for the rejuvenation of the upper and middle thirds of the face. Its minimally invasive nature reduces recovery times and minimal scarring while providing lasting and natural-looking results. The 22-year experience underscores the reliability and high patient satisfaction associated with MIVEL, making it a preferred choice for facial rejuvenation surgery. Future directions include further refining the technique and exploring its applicability to other facial and neck rejuvenation areas.</p>\",\"PeriodicalId\":12564,\"journal\":{\"name\":\"Frontiers in Surgery\",\"volume\":\"12 \",\"pages\":\"1634862\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-09-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497704/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fsurg.2025.1634862\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2025.1634862","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
22 years of Minimal Incision Vertical Endoscopic Lift: a journey in endoscopic facial rejuvenation.
Introduction: The Minimal Incision Vertical Endoscopic Lifting (MIVEL) is a minimally invasive facial rejuvenation technique that repositions tissues with minimal scarring, reduced recovery time, and long-lasting results, while achieving a natural appearance. This study aims to describe the updated MIVEL procedure, focusing on its evolution over 22 years and providing methodological details. This includes refining the indications, identifying key fixation points for reproducible results, and highlighting the long-term success of MIVEL as an effective approach for facial rejuvenation with minimal scarring and reduced complications.
Methods: This retrospective analysis encompasses a comprehensive review of 784 patients who underwent MIVEL between 2001 and 2023. The MIVEL technique involves small incisions, endoscopic guidance, and vertical lifting to reposition facial tissues. Preoperative and postoperative photographs, patients' demographic data, and complication rates were analyzed. Included patients were those seeking facial rejuvenation without extensive skin excision and attending all follow-up visits up to at least one year postoperatively. Patients were categorized into three MIVEL groups (I, II, III) of dissection, based on their age and related aging signs.
Results: The average age of patients was 50.5 years, with the majority falling in the MIVEL II group (53.1 years). MIVEL I was primarily performed on younger patients (21-35 years), while MIVEL III was reserved for those over 55 years. Adjunctive procedures, such as guided Superficial Enhanced Fat Fluid Injection (SEFFI), blepharoplasty, and neck lift, were commonly combined with the MIVEL procedure. The complication rates were low, with transient issues like neuropraxia and periocular ecchymosis being the most common. No cases of severe complications like skin necrosis or permanent nerve injury were reported.
Discussion: MIVEL has proven to be a highly effective and well-tolerated technique for the rejuvenation of the upper and middle thirds of the face. Its minimally invasive nature reduces recovery times and minimal scarring while providing lasting and natural-looking results. The 22-year experience underscores the reliability and high patient satisfaction associated with MIVEL, making it a preferred choice for facial rejuvenation surgery. Future directions include further refining the technique and exploring its applicability to other facial and neck rejuvenation areas.
期刊介绍:
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.