The surgeon operates under the deep layers of the face decreasing the risk of nerve damage.

"Some surgeons, to whom I have had an opportunity to teach these techniques, state that the learning curve of the midface as compared to the forehead lift is significantly steeper and technically more demanding. However, when the surgeon can master this technique, there is nothing that could replace it."

To allow the safer and easier surgery with the endoscopic midfacelift, Dr. Ramirez has recently designed a special elevator that he calls the minus series because they are small compared with the forehead lift instruments.