We will first introduce “endoscopic direct vision wrinkle reduction”. After the frontal and temporal skin laxity produces wrinkles, the scalp is separated, and due to the contraction effect after the flap is separated, and due to the backward tensing and fixation of the separated flap, and the contraction force of the occipital muscle, the scalp produces new upward and backward adhesions to achieve the purpose of wrinkle reduction. In this case, only a small incision is needed to cut the scalp to achieve the purpose of wrinkle reduction. Why is it used with caution for people with severe frontotemporal skin laxity? The reason is that endoscopic wrinkle reduction is a small incision without skin removal. For patients with severe frontotemporal skin laxity, the effect of frontotemporal rejuvenation may not be achieved without peeling because there is more loose skin. This is the reason why endoscopic wrinkle removal under direct vision should be used with caution in patients with severe frontotemporal skin laxity.