Shuttle-lifting of the neck; A percutaneous neck-lifting procedure
Goals/Purpose:
Thanks to the new concepts the attention of our efforts to restore youth shifted from skin/SMAS tractions to volume redistribution. MACS lift is an example of this effort to perform face-lifts through shorter incisions due to the help of suspension sutures. The next step is to achieve comparable and durable results with minimal invasive methods.
Methods/Technique:
Our quest was to access the surgical field through a small puncture, to redistribute the mid-facial volume, and/or to suspend no-undermined SMAS of the lower face by using strong, permanent purse string suspension sutures anchored to a more cranial periosteal point. This is obtained through a double sided needle or shuttle, smoothly anchoring the subcutaneous tissues to a more cranial periosteal point without drawing the skin. As soon as the gravitational force is compensated by the loop suspensions, skin redraping is achieved through the inherent retraction capacity of the skin, which is undermined by liposuction cannulas.
Results/Complications:
Our technique for the mid-face and neck was applied in selected 186 patients between December 2005 and September 2010 with a follow-up changing from 8 months to 24 months. The mean age of the patients was 42 ½ years. Outcomes were satisfactory in all but 10 cases, of which 7 found the result inadequate. Three patients requested the neck suture detached because of long-lasting pain and discomfort. Operation time was less than 40 minutes under local or sedative anesthesia for a neck suspension in all patients with an uneventful rapid recovery. The recovery time was 3-7 days.
Conclusion:
The core principle of shuttle-suspension of the neck is putting strong, non-absorbable purse-string sutures on non-undermined SMAS by a shuttle and anchoring it to a fixed pivot point through just punctures. Skin resection is not done, the gravitational force is compensated by the suspensions and skin redraping is achieved through the inherent retraction capacity of the undermined skin in related localization. In selected patients, this scarless method can be quickly performed under local anesthesia with long term durability, low morbidity and high patient satisfaction rate.
Picture 1: A minimal
invasive combination treatment: Mid-facial tissue injection and cross neck
shuttle-suspension. Postop. 1 year.
