As the years go by, aging of the face is inevitable. The skin begins to loosen in the face and the neck giving way to "crow's feet" at the corner of the eyes, jowling at the jawline, deep folds or"marionette lines" at the corner of the mouth, and vertical folds and a "double chin" beneath the chin. Heredity, sun exposure, the pull of gravity, and personal habits such as smoking contribute to the aging of the face. In recent years, there has been a technologic revolution in all areas of surgery. Where doctors used to use large incisions to perform abdominal surgery, heart surgery and spine surgery, the same surgeries are now performed through smaller insisions using endoscopes (telescopes). This has resulted in less scarring, and shorter recovery times without compromising safety or results. This technologic revolution has now become a part of facelifting surgery. To reverse the changes of facial aging a procedure called an Endoscopic Facelift can be performed. Andrew A. Jacono, M.D. is a Facial Plastic and Reconstructive Surgeon who has experience treating hundreds of patients with endoscopic facelifts. He is Director of the New York Center for Facial Plastic and Laser Surgery, and has recently published his results with endoscopic facelifts in the May 2003 issue of the medical journal Facial Plastic Surgery. This procedure is usually performed on men and women between the ages of forty and sixty, but in some is necessary at an earlier age. Doctor Jacono explains "Endoscopic Facelifts tighten facial muscles and lifts facial skin without the long and visble scars of older facelift techniques. The incisions are hidden in the hairline and thus are not visible. It is essentially a "scarless" procedure." Doctor Jacono uses an endoscope the size of a drinking straw for visualization through these small incision. "The endoscopic facelift procedure is a complex surgery, and requires a high degree of expertise and experience", warns Doctor Jacono. "Few doctors have this level of experience as the procedure has only been developed over the last 5 years. Doctors who specialize in facial plastic surgery (not generalists) and are credentialed either through The American Academy of Facial Plastic and Reconstructive Surgery or the American Society of Plastic and Reconstructive Surgeons are good choices."