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.
What is an endoscopic facelift?
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
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
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)
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
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.
Dr Tim Janssen’s Hybrid Endoscopic Facelift Featured on Channel 4
The Channel 4 team followed Joyce from her initial consultation through surgery and recovery for Episode 3 of Surgery Secrets of the Super Rich. With a television crew capturing every stage of the operation, there was no room for error as Dr Tim Janssen performed a Hybrid Endoscopic Face, Brow and Neck Lift, offering viewers an unfiltered insight into the procedure
Follow Joyce’s Hybrid Endoscopic Facelift journey on Channel 4 →
What Makes the Endoscopic Scarless Facelift Different?
Across all three techniques, the Endoscopic Scarless Facelift is defined by several key principles.
Hidden incisions
Vertical lifting
Anatomical preservation
Natural results
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.
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.
Case 1
Endoscopic HI Lift™
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.
Case 2
Hybrid Endoscopic HI Face and Neck Lift™
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.
Case 3
Endoscopic HI Face and Neck Lift™
Procedure: Endoscopic Scarless Browlift, Face and Necklift
Profile-view at 6 months following comprehensive scarless facial rejuvenation surgery.
Case 4
Revision Endoscopic HI Lift™
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.
Case 5
Endoscopic HI Face and Neck Lift™
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
Case 6
Hybrid Endoscopic HI Face and Neck Lift™
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
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
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.
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.
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Frequently Asked Questions
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.
