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Endoscopic Facelift London. The Ponytail Facelift.

Scarless, Hidden Incision Facelift by Dr Tim J. Janssen.

The endoscopic facelift is a minimally invasive deep plane technique that repositions the deeper structures of the face without the need for visible incisions in front of the ears. Often referred to as a "scarless facelift" or "ponytail facelift", this approach focuses on restoring natural facial structure rather than pulling the skin.

WaterhouseJanssen is the UK's first high-volume practice in scarless endoscopic facelift surgery.

Line artwork of a lady depicting endoscopic S-Ponytail facelift

What is an endoscopic facelift?

An endoscopic facelift uses a high-resolution camera system to lift the deep tissue layers (deep plane) through incisions completely hidden in the hairline. The goal is to harmoniously mobilise deeper anatomical layers as a unit to minimize tissue trauma.

In contrast to traditional facelift techniques, including the deep plane facelift, this method is characterized by:

- A more vertical tissue repositioning instead of a lateral pull
- Complete preservation of the superficial vascular and lymphatic channels
- No facelift scars in front of the ear or at the hairline due to minimally invasive access
- A reduction in soft tissue trauma and a shorter recovery period

Dr. Janssen applies the endoscopic technique in three clearly defined facelift procedures, which are selected based on facial anatomy and aging patterns. Patients often compare this approach to a Deep Plane Facelift or other conventional facelift operations. Although the indications for these techniques may overlap, they differ significantly in terms of scar placement, vector of lift, and tissue trauma. A detailed explanation can be found in our article Endoscopic vs. Deep Plane Facelift.

The Types of Endoscopic Facelifts

Dr. Tim J. Janssen, specialises in endoscopic facelifting techniques designed to address facial ageing in patients seeking undetectable results. 

Each technique is tailored to different stages of facial ageing, from early midface descent to more advanced lower face and neck laxity.

1. The HI Lift™

Hidden Incision Endoscopic Deep Plane Face and Brow Lift (Ponytail Lift)

The HI Lift™ is designed for patients with early signs of facial ageing, particularly affecting the brow and midface.

Areas treated

  • Brows
  • Midface and cheeks
  • Corners of the mouth
  • Early to moderate jowling
The starting price for the The HI Lift™ is £30,000
Prices are a guide. Your final treatment plan and investment will be confirmed following your consultation.
Before
After

Key features

  • Endoscopic deep plane lift of the brow and face
  • Vertical vector lifting to restore youthful proportions
  • Hidden incisions within the hair and undetectable scars
  • No incisions around the ears
  • Preserves natural anatomy

This procedure is ideal for patients seeking subtle rejuvenation without addressing the neck or lower face.

Who is this best for?

Best suited for:

  • Early to moderate ageing (30s to 50s)
  • Brow and midface descent, early jowls
  • Filler associated facial heaviness
Before
After

2. HI Lift™ Face and Necklift

Scarless Face, Brow and Neck Lift

The Endoscopic HI Face and Neck Lift combines the scarless Face and Brow lift  (Ponytail lift) with a Hidden Incision Neck Lift, addressing both facial descent and neck laxity for comprehensive, undetectable face and neck rejuvenation.

Areas treated

  • Eyebrows and temporal region
  • Lower eyelids
  • Midface and cheeks
  • Corners of the mouth (downturned)
  • Mild to moderate jowls
  • Neck and submental region (area under the chin)
The starting price for the Endoscopic HI Face and Neck Lift is £37,500.
Prices are a guide. Your final treatment plan and investment will be confirmed following your consultation.

Key features

  • Endoscopic lifting of the face as well as the temporal region and forehead in the deep layers (deep plane)
  • Additionally, the neck is tightened via hidden incisions in the posterior ear crease
  • Lifting in the vertical vector to restore natural proportions
  • Hidden scars in the hairline
  • No incisions around the ears 

Who is this best for?

Best suited for:

  • Moderate ageing (35 to 60)
  • Brow, face and neck descent
  • Filler associated facial heaviness

The Hybrid HI Lift™

Endoscopic Face, Brow and Neck Lift combined with lower Deep Plane Facelift

The Hybrid HI Lift™ Face and Necklift is the most comprehensive endoscopic facelift performed by Dr Janssen. It addresses ageing across the entire face and neck while maintaining a natural, unoperated appearance with minimal scars.

Areas treated

• Brow
• Midface and cheeks
• Lower face including jowls
• Jawline
• Neck

The starting price for the Hybrid HI Face and Neck and Jowl Lift is  £44,500
Prices are a guide. Your final treatment plan and investment will be confirmed following your consultation.
Before
After

Key features

  • Endoscopic deep plane Face and Brow Lift
  • Open approach deep plane lower face and jowl correction
  • Hidden incision deep plane neck lift
  • Vertical repositioning of facial tissues
  • Avoids the visible temporal and hairline scars often associated with traditional facelifting
  • No distortion to the hairline

Who is this best for?

Best suited for:

  • Moderate to advanced ageing
  • Patients with advanced lower face laxity
  • Filler associated facial heaviness

This technique is ideal for patients with more advanced facial ageing who wish to avoid the scars around the ear and hairline distortion associated with traditional facelift surgery.

What Makes the Endoscopic Scarless Facelift Different?

Across all three techniques, the Endoscopic Scarless Facelift is defined by several key principles.

Hidden incisions

All incisions are placed within the scalp or behind the ear, avoiding scars in the face and preserving the hairline and ear anatomy. While often described as a scarless facelift, this refers to the absence of visible scars, as incisions are concealed within the hairline.

Vertical lifting

Facial tissues are lifted in a vertical direction, counteracting gravitational descent without creating a windswept or overpulled appearance. Endoscopic facelift surgery relies on deep plane repositioning rather than extensive skin excision, allowing the underlying structures to be restored while preserving a natural facial appearance.

Anatomical preservation

Skin, fat, and the SMAS layer are lifted together, maintaining blood supply and reducing surgical trauma.

Natural results

The goal is refinement rather than reinvention, preserving facial identity while restoring youthful structure.

Read more about the Endoscopic Facelift here.

Who Is a Suitable Candidate?

Patients suitable for an endoscopic facelift typically present with:

  • Early to advanced facial descent, good skin quality preferable
  • Midface volume loss or drooping, including under eye hollowness
  • Brow descent or heaviness
  • Neck laxity with or without jowling
  • Relatively good skin quality and elasticity

Where skin quality is reduced, adjunctive treatments such as CO₂ laser resurfacing may be recommended.

Endoscopic Facelift B&A

Patients seeking natural rejuvenation rather than dramatic change are best suited to this approach.  As ELLE magazine recently reported, we’ve officially entered the “Undetectable Era” of plastic surgery, and the Endoscopic Facelift is just that. You can read more about this here.

A personalised facelift consultation is essential to determine which of the three techniques is most appropriate. Click here to get in touch with a team member.

Endoscopic Facelift Before and After Gallery

Below are examples of Dr Tim Janssen’s endoscopic facelift results. Individual outcomes vary depending on anatomy, skin quality, age, previous filler, and whether additional procedures such as neck lift, brow lift, blepharoplasty or CO₂ laser were performed.

Before and after scarless facelift, three-quarter oblique view, 12 weeks post-op

Case 1
Endoscopic HI Lift™

Age: 43
Procedure: Endoscopic Scarless Face and Browlift (Ponytail Facelift)

Three-quarter view at 12 weeks following an endoscopic facelift performed through 15mm incisions concealed in the hairline.
hybrid endoscopic scarless facelift before after 12weeks

Case 2
Hybrid Endoscopic HI Face and Neck Lift™

Age: 54
Procedure: Hybrid Endoscopic Browlift, Face and Necklift including Jowli-lift

Three-quarter view at 14 weeks following endoscopic Facelift surgery for advanced signs of facial ageing.
endoscopic face and necklift before after 6 weeks

Case 3
Endoscopic HI Face and Neck Lift™

Age: 43
Procedure: Endoscopic Scarless Browlift, Face and Necklift

Profile-view at 6 months following comprehensive scarless facial rejuvenation surgery.
revision endoscopic facelift before after 12 weeks

Case 4
Revision Endoscopic HI Lift™

Age: 51
Procedure: Revision Endoscopic Scarless Face and Browlift (Ponytail Facelift)

Three-quarter view at 12 weeks following a complex revision after a Deep Plane Facelift 3 years ago with a different surgeon.
Before and after long-term endoscopic face and necklift result by Dr Tim Janssen

Case 5
Endoscopic HI Face and Neck Lift™

Age: 50
Procedure: Endoscopic Scarless Browlift, Face and Necklift (Longterm result)

Three-quarter view showing the long term results beyond 1 year following a comprehensive scarless Facelift, Browlift, and Necklift
Before and after hybrid endoscopic face and necklift result by Dr Tim Janssen in London

Case 6
Hybrid Endoscopic HI Face and Neck Lift™

Age: 61
Procedure: Hybrid Endoscopic Browlift, Face and Necklift including Jowli-lift

Front view at 4 months following a Endoscopic deep plane Facelift, Browlift, and Necklift as well as lower facelift.

Operative Details and Anaesthesia

All endoscopic facelift procedures are performed under general anaesthesia following a full preoperative assessment.

Typical operating times:

  • Hidden Incision Facelift (Ponytail Lift): 3 to 4 hours
  • Hidden Incision Face and Necklift: 4 to 6 hours
  • Hybrid Endoscopic Face, Jowl and Neck Lift: 6 to 8 hours

Procedures may be performed as a day case or with an overnight stay depending on the extent of surgery.

Recovery After an Endoscopic Ponytail Facelift

Woman steps of s ponytail facelift recovery

Typical recovery timeline:

  • Days 1 to 5: skin coloured tape may be used to help support swelling and bruising
  • Around 2 weeks: most patients feel socially presentable
  • 6 weeks: swelling largely resolved
  • 12 weeks: final results visible

Adjunctive therapies may include:
• Lymphatic drainage therapy 
• Hyperbaric oxygen therapy 

Woman between 2 statues

Complementary Procedures

Endoscopic facelift surgery can be combined with other procedures for balanced facial rejuvenation, including:

  • Neck lift
  • Upper blepharoplasty
  • Lower blepharoplasty
  • Lip lift
  • CO₂ laser
  • Facial fat transfer

Complementary procedures are discussed during your consultation and tailored to individual anatomy. You can read more about our complementary procedures here.

Safety and Longevity of the Endoscopic Ponytail Facelift

Advantages include:

  • No ear or tragus distortion, helping to preserve a natural appearance
  • Full preservation of vascular and lymphatic structures to the skin
  • No Facelift scars

All risks including haematoma, infection, sensory changes, and asymmetry are discussed in detail during consultation.

Results typically last 10 to 15 years, depending on genetics, lifestyle, and ageing.

Patient resting during recovery after an endoscopic scarless facelift in London
Before and 1 year after Endoscopic HI Lift™ Face and Necklift

Postoperative Care and Follow Up

All patients receive:
• Regular postoperative appointments
• Direct access to the clinical team
• Optional recovery therapies to support healing

To arrange an endoscopic facelift consultation in London, you can get in touch with a team member here.

Postoperative Care & Follow-Up

Book a Private Consultation

For further information, or to book a consultation, please fill out the form below (in confidence) and a member of our team will contact you:

Frequently Asked Questions

Answers to common questions about our facial procedures, recovery, and consultations at our London clinics.
Learn more
At WaterhouseJanssen, we focus exclusively on facial rejuvenation. Our surgeons specialise in advanced techniques including the deep plane facelift, endoscopic (scarless) facelift, neck lift, brow lift, eyelid surgery, and complementary procedures.
Our clinic is led by Mr Norman Waterhouse and Dr Tim Janssen. Mr Waterhouse is internationally recognised for his expertise in revision and complex facelift surgery, while Dr Janssen is a leading surgeon in endoscopic (scarless) facelifting.
Consultations can be arranged by contacting us through our website, Instagram or calling +44 20 7636 4073. We recommend an in-person consultation, though online consultations are also available for patients based abroad.
Your surgeon will review your medical history, examine your facial anatomy, and discuss your concerns and goals. Together, you’ll explore suitable treatment options, expected outcomes, recovery, and the likely next steps.
All surgeries are performed in accredited hospitals in central London, Zurich and Dubai, ensuring the highest levels of safety and care. Our partner hospitals in London include the London Clinic, Weymouth Street Hospital and 101 Harley Street.
Mr Waterhouse runs all his consultations from The London Clinic, whilst Dr Janssen will primarily see patients at 101 Harley Street.
Most patients feel comfortable returning to light activities and work after 2–3 weeks, depending on the procedure. Your surgeon will guide you on when it is safe to resume exercise, social events, and travel.
Yes. We provide comprehensive aftercare, including follow-up appointments for suture removal, progress checks, and reviews with your surgeon.

Yes. Many of our patients travel internationally to see our surgeons. We offer virtual consultations, assist with scheduling around travel, and can recommend trusted accommodation near our Harley Street clinic.

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Phone: +44 20 7636 4073
Email: karen@theaestheticsurgeons.com

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