Ponytail Lifts, Scarless Facelifts, and Endoscopic Facelifts – Simplified Explanation and Comparison.

February 21, 2026 | Facelift

Introduction
In this blog, you will learn about ponytail facelifts, scarless facelifts, and endoscopic face
lifts and hidden scar face lifts. You will learn what an endoscope does and how it
facilitates the broad category of hidden scar facelifts. You’ll also learn how to distinguish
hidden scar endoscopic facelifts from traditional facelifts.
What is a Ponytail Lift and What is a Scarless Facelift?
Both ponytail lifts and scarless face lifts are rejuvenating surgical procedures of the face
and neck. What makes them special is that they are performed without the typical
visible incisions used in traditional face and neck lifts. Therefore, these procedures have
meaningful results without scars in highly visible areas.
A ponytail lift and a scarless facelift are names attributed to a special class of face and
neck lift performed with an endoscope. An endoscope can be thought of as a small
camera at the end of a stick that can be placed underneath the surface of the skin to
allow visualization of tissue being manipulated during surgery. Face lifts and neck lifts
performed this way are generally called endoscopic facelifts and necklifts.
The endoscope needs to be placed through an incision and all incisions do result in
scars, so it is a little bit of a misnomer to call it a scarless facelift. It might be more
appropriate to call it a facelift with less scars. Nonetheless, there is a real advantage to
performing endoscopic face and neck lifts because using the camera at the end of the
stick allows incisions to be small and placed in locations where they are very difficult to
see and perhaps, for all practical purposes, are invisible.
Typically, endoscopic face and neck lifts require 6 to 7 small incisions that each are
about an inch long. Each side of the face and neck has three incisions, and there is one
small incision that sometimes is located beneath the chin. The three incisions on the
side of the face are located at the lower lateral forehead, the sideburn area, and behind
the earlobe. Because of the presence of the hair and because of the location behind the
ear, when the incisions heal the scars are very difficult to see.
Endoscopic face lifts are typically facelifts performed in the deep plane. A composite
cheek flap is elevated, ligaments are released, and the tissue is elevated and supported
to the tougher tissues around the temporalis major muscle called the deep temporal
fascia.
A composite flap refers to a multi layer segment of cheek tissue that includes the SMAS
(subcutaneous musculo aponeurotic system) and the overlying skin.

An endoscopic facelift often involves providing brow support or even a brow lift. The
brow and the facial dissection occur through the two incisions located in the hair. The
neck dissection occurs through the incision located behind the ear. The neck dissection
occurs mostly in the sub platysmal plane.
The incision beneath the chin, also called the submental incision, is used for accessing
the midline sub platysmal tissues. These tissues often require reduction and include the
anterior belly of the digastric muscle and the submandibular gland. Reducing these
tissues creates smooth neck contours and definition of the overlying jaw bone.
In summary, ponytail lifts and scarless facelifts are part of a broader category of
endoscopic facelifts. Endoscopic face lifts take advantage of a camera on the end of a
stick to perform surgery under the surface of the skin through very small and well
hidden incisions. The facelift that is performed is a deep plane facelift and neck lift.
These procedures are ideal for patients who require reversal of the shape changes that
occur with age, but do not have a lot of excess skin. An endoscopic facelift can restore
volume in the cheek by elevating the malar fat pad back up onto the bony structure of
the cheek. The benefit of this is to restore proportions of youth that include increased
volume in the upper half of the face in comparison to the lower half of the face.
Adam Bryce Weinfeld, M.D. is a specialized facial aesthetic plastic surgeon performing
both traditional facelift and endoscopic facelifts in Austin, Texas.
Frequently Asked Questions About Ponytail Lifts,
Scarless Lifts, and Endoscopic Facelifts
Are ponytail lifts and scarless face lifts actually scarless?
No. These are surgical procedures that require incisions. Incisions result in scars. The
real magic of a ponytail or scarless facelift is that the scars are placed in areas where, in
almost all circumstances, they are impossible to see.
Is an endoscopic hidden scar facelift the same as a ponytail lift or a scarless
facelift?
Yes, in a general sense these are all the same or very similar procedures.
Is a high SMAS or deep plane facelift a ponytail or a scarless facelift?
No. When people talk about SMAS facelifts or deep plane facelifts, they are generally
talking about traditional facelifts with the traditional placement of scars, usually around
the sideburn, in front of the ear, and behind the ear.
Are ponytail facelifts and scarless facelifts SMAS or deep plane facelifts?
Yes, in a sense. I know this is where things get confusing, but the real power of a
ponytail lift, or a scarless facelift, or an endoscopic facelift is that they do involve a
dissection beneath the SMAS tissue. The pattern of that dissection may be a high
SMAS pattern, or it may be a deep plane pattern. So high SMAS and deep plane

facelifts are generally the terms used to describe lifts with a traditional incision and scar
pattern, and therefore they are not truly endoscopic facelifts. Endoscopic facelifts do
work beneath the deeper tissue and therefore may be high SMAS or deep plane
facelifts.
Do ponytail lifts, scarless facelifts, and endoscopic face lifts involve a brow lift or
brow reset?
Yes, generally most of these procedures do involve some adjustment of the eyebrow
within an endoscopic approach.
Do ponytail lifts, scarless facelifts, and endoscopic face lifts include a neck lift?
Yes, generally these types of face lifts involve a neck lift as well.
What is an endoscope?
An endoscope is a surgical tool that can be thought of as a camera on the end of a stick
that can be placed through very small incisions in hidden locations to perform the key
maneuvers of a facelift without traditional scars.
What would be the most descriptive name for a ponytail lift or scarless facelift?
A hidden scar endoscopic face, brow, and neck lift.
About the Author
Adam Bryce Weinfeld, M.D. — Serving the Austin Metropolitan area including Westlake,
Tarrytown, Rollingwood, Sunset Valley, Northwest Austin, Round Rock, Cedar Park,
Liberty Hill, Georgetown, Florence, New Braunfels, San Marcos, San Antonio, and
Waco. Ask about Dr. Weinfeld’s travel program for patients elsewhere in Texas, the
United States, or located abroad. Dr. Weinfeld is a board-certified plastic surgeon with
17 years of experience with facelifts. He specializes in facial aesthetic plastic surgery
and completed two cosmetic surgery fellowships. He also has training as an
oculoplastic surgeon.