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Excision of excess skin and Z-plasty closure necklift – experience in the female population

Joanna H. Ng-Glazier, MD Guy M. Stofman, MD
University of Pittsburgh Medical Center
2018-02-05

Presenter: Joanna H. Ng-Glazier

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I attest that the above is true.

Director Name: Vu T. Nguyen, MD

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics

Background: Necklift to reverse effects of aging and tighten excess skin is often performed in conjunction with rhytidectomy in the female population. Simpler, direct anterior approaches have been described in men and less so in women. We describe a series of women who underwent direct excision of excess skin with z-plasty closure with excellent success.

Methods: Four women underwent direct excision and z-plasty closure necklift by a single surgeon over a period of two decades in a busy aesthetic practice. All women presented with the so-called "turkey gobbler" deformity, either from aging or history of massive weight loss, with desired removal of excess skin. Women were followed every month or more frequently out to 10 years with serial photographs. Improvement in cervicomental angle, as well as subjective satisfaction and cosmetic ratings were measured in both AP and lateral views.

Results: All four women had good short and long-term cosmetic outcomes with desired improvement in cervicomental angle. There were no described complications or need for revision. All incisions were designed in the midline, and platysmal plication and hand lipectomy were performed above the level of the muscle in all four women.

Conclusion: Necklift via excision of excess skin with Z-plasty closure is a simple and reproducible alternative in a select population of women who desire minimal manipulation or may not be suitable candidates for a larger combined facelift procedure.

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