Endoscopic Technique

Many surgical procedures can be performed using an endoscope, a special instrument that allows our experienced plastic surgeon, Dr. Neal Goldberg, to view the internal structures of the body through tiny incisions. This unique tool looks like a long cylindrical tube with a camera and a light at one end and a viewing screen at the other. When the endoscopic probe is placed inside an incision, the image of the surgical field will be magnified and displayed on the screen. In this way, Dr. Goldberg can better observe the fine details of a procedure as he moves the endoscope around the area being treated.

The endoscope is not designed to perform a procedure; this device only serves to improve Dr. Goldberg’s ability to view the internal areas during surgery. Other surgical instruments will be utilized through a separate access point and maneuvered within the body to complete the operation.

For more information about endoscopy or to schedule an in-person visit with Dr. Goldberg, please contact us today.

Benefits Of Endoscopy

Diminished Risk Of Scarring

With every incision there is a risk of scarring; however, endoscopic surgery typically utilizes smaller incisions placed in less conspicuous locations than in “open” surgical procedures. As a result, scars often are smaller and less noticeable than with traditional surgery, and some other common side effects also may be minimized.

Shorter Incisions

The camera attached to the endoscope allows Dr. Neal Goldberg to clearly see the treatment area without utilizing large incisions. Most endoscopic procedures require a few small openings, and the probe and accompanying instruments can be inserted into incisions approximately one inch in size or smaller. Each procedure requires a different number of incisions. For instance, breast augmentation often involves only two, while a brow lift may call for three or four small incisions. Dr. Goldberg strives to create as few incisions as possible and place them in the least visible locations

Reduced Risk Of Nerve Damage

Sensory loss due to nerve damage is a common concern for patients undergoing surgery; however, since the incisions are much smaller during an endoscopic procedure, this risk is significantly diminished. Additionally, side effects such as bleeding, swelling, and bruising may also be milder, and in many cases patients are able to return to work faster. Compared with open surgery, an endoscopic approach typically allows for a speedier recovery.

Return To Normal Activities Sooner

Many endoscopic surgeries can be performed as outpatient procedures, as they typically utilize local anesthesia with sedation. As a result, most patients can return home the same day as the operation, with no overnight stay in the hospital. Dr. Goldberg will discuss your options with you in advance of the operation and determine whether your procedure can be performed on an outpatient basis.

Endoscopic surgery offers a variety of benefits, and research suggests there could be a number of additional applications. Currently, many plastic surgeons like Dr. Goldberg are already utilizing the endoscopic technique for cosmetic and reconstructive treatments.

Qualified patients may benefit from the endoscopic approach in the following procedures:

Cosmetic Surgery

Tummy Tuck (abdominoplasty)

Designed to reduce loose skin and tighten the abdominal muscles, tummy tuck surgery often can be aided by the endoscopic technique. Dr. Goldberg will employ the endoscope to better view the muscles that run vertically along the abdomen, and then tighten them through very small incisions. Though typically effective in helping to correct muscle laxity, endoscopy usually will not be used on patients with a substantial amount of excess abdominal skin.

Breast Augmentation

Often used to help place the breast implants during breast augmentation, Dr. Goldberg can insert the endoscope through a tiny incision in the navel or underarm area to help achieve the best possible position for the implants within the chest wall. Furthermore, the endoscopic technique can help our plastic surgeon evaluate existing breast implants, as well as potentially aid in the treatment of capsular contracture.


The traditional facelift procedure remains the best option for patients with a significant degree of facial skin laxity. In many cases an endoscopic facelift can be performed. Typically, an endoscope-assisted procedure allows Dr. Goldberg to eliminate the need for excessive incisions made along the hairline and instead place them only in the areas that require the greatest treatment. For instance, a hidden incision often can be made along the upper gumline or within the lower eyelid to tighten and smooth the muscles and skin of the mid-face and cheeks. Loose muscles on the neck may be tightened through a well-concealed incision located behind the ears and beneath the chin. Furthermore, when positioning cheek and chin implants the endoscopic technique can prove particularly advantageous.

Forehead Lift – Brow Lift

The cosmetic procedure that is most commonly performed using an endoscope is the forehead lift (brow lift). The endoscopic technique can dramatically reduce the size of the incision typically required to just a few tiny openings made along the hairline. Dr. Goldberg can use the endoscope to guide him while he repositions the eyebrows to a higher, more youthful level and removes the muscles responsible for producing frown lines and creases that run along the forehead.

Reconstructive Surgery

Flap Surgery

Dr. Goldberg often utilizes the endoscopic technique when correcting damage to the body due to injury or illness. During flap surgery, healthy tissue from one area of the body can be transplanted to help reconstruct another. The endoscope typically allows Dr. Goldberg to remove the flaps from the donor site using only a few small incisions.

Tissue Expander Placement

Silicone balloons called tissue expanders are designed to gradually stretch the healthy skin in a donor site for use in the repair of an injury where skin is missing or damaged, often due to a burn or disease. These temporary devices are commonly used in reconstructive surgery and need to be placed properly for the greatest benefit. Dr. Goldberg typically utilizes an endoscope to aid in positioning the tissue expander beneath the skin to achieve the best possible results.

Sinus Surgery

The narrow passageways of the sinuses often are more easily explored using an endoscope. Dr. Goldberg can employ the endoscopic technique to locate and repair sinus-drainage issues, polyps (growths), and other issues located in the nasal cavity. Additionally, he may be able to use an endoscope to guide him during rhino-septal surgery.

Carpal Tunnel Treatment

Dr. Goldberg can often employ the endoscopic technique to aid in the correction of carpal tunnel syndrome. In most cases, he will insert the endoscope through a small incision located on the wrist and pinpoint the nerve running down the center of the hand, called the median nerve. Additionally, he may create a separate incision on the palm to address the ligament that typically places pressure on this nerve.

Additional Considerations And Risks

The endoscope offers an innovative approach to surgery; however, the approach is still in the infancy stages of use for cosmetic procedures. Some of the potential risks associated with the endoscopic method include:

  • Infection
  • Nerve damage or sensory loss
  • Fluid accumulation beneath the skin (which must be drained)
  • Blood vessel damage
  • Skin injury
  • Internal perforation injury

Risk of complications will vary depending on the specific procedure and the unique indications of the patient. In every case, Dr. Goldberg will strive to provide the safest, most effective treatment possible.

It is important to note, Dr. Goldberg may have to divert to an open surgery from an endoscopic surgery if complications should develop. In this instance, a longer recovery period and a more extensive scar may result; however, complications typically are rare, occurring in approximately five percent or less of all endoscopic operations.

Am I a Candidate for Endoscopic Surgery?

The endoscopic approach has been utilized successfully in a variety of surgical fields for decades, including orthopedics, gynecology, and urology. Technological advances now allow extensively trained plastic surgeons like Dr. Goldberg to use this innovative technique in their cosmetic and reconstructive treatments. Endoscopic surgery potentially offers the same effective results as open procedures but with less scarring and potentially less downtime.

Qualified candidates for an endoscopic procedure will not have a substantial amount of loose, excess skin. A combination of traditional and endoscopic approaches may benefit patients with moderate to significant skin laxity who are seeking facelift, forehead lift, and/or abdominoplasty.

If you have additional questions about endoscopic surgery, or if you wish to schedule a consultation with Dr. Goldberg, please contact our office today.