Background:
Controversy exists regarding the optimal procedure to rejuvenate the aging neck. More-invasive procedures have increased risks of complications, while less-invasive approaches may deliver marginal results. The challenge has been to select the appropriate procedure that will deliver consistent, durable results that meet both the patient and surgeon's expectations.
Goals/Purpose:
We present a less-invasive approach to neck rejuvenation that appears to be long lasting with almost 3 years follow-up. The Trampoline Platysmaplasty (TPP) is a percutaneous suture suspension necklift that was first performed in October 2007.
Methods/Technique:
A retrospective study was conducted of 105 consecutive patients who underwent the TPP by two surgeons (GPM, NL). Patients either had the TPP alone, or as an adjunct to a facelift. Age, sex, procedure(s) performed, complications, and patient satisfaction were recorded. Patient selection criteria and the technique and specialized instrumentation are described. Cadaver studies were conducted by (GPM, SJA) to compare the tensile strength of the ligaments that anchor the TPP to the tensile strength of the sutures placed to approximate the medial platysma borders.
Results/Complications:
105 patients underwent the TPP between October 2007 and June 2009. TPP alone (18 females, 24 males), TPP with facelift (35 females, 28 males), average age 52 y/o, range 23 to 80 y/o, average length of follow-up was 28 months with a range of 6 to 34 months. Patient satisfaction was high, with 3 early patients undergoing immediate revision to improve results secondary to the suture matrix being too loose. Six additional patients had recurrent banding in about one year post-op. Replacing the matrix with the lighted rod resulted in correction in all six patients. The tensile strength of the retaining ligaments was statistically the same as the medial platysma borders.
Conclusion:
The TPP is a less-invasive option for neck rejuvenation, which is effective and durable in properly selected patients. It works well as a stand-alone procedure and with facelifts. It also offers younger patients a less-invasive option to improve neck contours inherited through genetics. With almost 3 years of follow-up, the results appear to be long lasting.
Figures:
Completed matrix
MediVisuals, Inc.: Dallas, TX, 2010.
34 y/o male s/p SAL and TPP: Before, profile
34 y/o male s/p SAL and TPP: 24 months Post-Op, profile
57 y/o female s/p ant. FL, SMAS plication, SAL and TPP: Before, profile
57 y/o female s/p ant. FL, SMAS plication, SAL and TPP: 24 months Post-Op, profile