Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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A Modified, Direct Neck Lift Technique: The Cervical Wave-Plasty

  • Parsa, Fereydoun Don (Department of Surgery, Division of Plastic Surgery, University of Hawai'i, John A. Burns School of Medicine) ;
  • Castel, Nikki (University of Hawai'i, John A. BURNS School of Medicine) ;
  • Parsa, Natalie Niloufar (Department of Family Practice, University of Hawai'i, John A. Burns School of Medicine)
  • Received : 2015.08.21
  • Accepted : 2015.10.19
  • Published : 2016.03.18
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Abstract

Background Major problems with cervicoplasty by direct skin excision include the subjective nature of skin markings preoperatively and the confusing array of procedures offered. This technique incorporates curved incisions, resulting in a wave-like scar, which is why the procedure is called a "wave-plasty". Methods This prospective study includes 37 patients who underwent wave-plasty procedures from 2004 to 2015. Skin pinching technique was used to mark the anterior neck preoperatively in a reproducible fashion. Intra-operatively, redundant skin was excised, along with excess fat when necessary, and closed to form a wave-shaped scar. Patients were asked to follow up at 1 week, 6 weeks, and 6 months after surgery. Results The mean operation time was 70.8 minutes. The majority (81.3%) was satisfied with their progress. On a scale of 1 to 10 (1 being the worst, and 10 being the best), the scars were objectively graded on average 5.5 when viewed from the front and 7.3 when seen from the side 6 months after surgery. Complications consisted of one partial wound dehiscence (2.3%), one incidence of hypertrophic scarring (2.3%), and two cases of under-resection requiring revision (5.4%). Conclusions In select patients, surgical rejuvenation of the neck may be obtained through wave-like incisions to remove redundant cervical skin when other options are not available. The technique is reproducible, easily teachable and carries low morbidity and high patient satisfaction in carefully chosen patients.

Keywords

References

  1. Rohrich RJ, Rios JL, Smith PD, et al. Neck rejuvenation revisited. Plast Reconstr Surg 2006;118:1251-63. https://doi.org/10.1097/01.prs.0000209406.80690.9f
  2. Ramirez OM. Cervicoplasty: nonexcisional anterior approach: a 10-year follow-up. Plast Reconstr Surg 2003;111:1342-5. https://doi.org/10.1097/01.PRS.0000047025.35228.2C
  3. Miller TA. Excision of redundant neck tissue in men with platysma plication and Z-plasty closure. Plast Reconstr Surg 2005;115:304-13.
  4. Chaput B, Grolleau JL, De Bonnecaze G, et al. Anterior medial cervicoplasty. Ann Chir Plast Esthet 2012;57:612-7. https://doi.org/10.1016/j.anplas.2011.11.006
  5. Bitner JB, Friedman O, Farrior RT, et al. Direct submentoplasty for neck rejuvenation. Arch Facial Plast Surg 2007;9: 194-200.
  6. Bruneau S, Nguyen P, Foletti JM, et al. Neck rejuvenation by anterior cervicoplasty: an original technical modification. J Plast Reconstr Aesthet Surg 2013;66:1627-8. https://doi.org/10.1016/j.bjps.2013.05.039
  7. Jordan JR, Yellin S. Direct cervicoplasty. Facial Plast Surg 2014;30:451-61. https://doi.org/10.1055/s-0034-1383553
  8. Sugai DY, Deptula PL, Parsa AA, et al. The importance of communication in the management of postoperative pain. Hawaii J Med Public Health 2013;72:180-4.
  9. Parsa AA, Sprouse-Blum AS, Jackowe DJ, et al. Combined preoperative use of celecoxib and gabapentin in the management of postoperative pain. Aesthetic Plast Surg 2009;33: 98-103. https://doi.org/10.1007/s00266-008-9230-y
  10. Parsa AA, Soon CW, Parsa FD. The use of celecoxib for reduction of pain after subpectoral breast augmentation. Aesthetic Plast Surg 2005;29:441-4. https://doi.org/10.1007/s00266-005-0032-1
  11. Conway H. The surgical face lift--rhytidectomy. Plast Reconstr Surg 1970;45:124-30. https://doi.org/10.1097/00006534-197002000-00003
  12. Kamer FM, Frankel AS. Isolated submentoplasty: a limited approach to the aging neck. Arch Otolaryngol Head Neck Surg 1997;123:66-70. https://doi.org/10.1001/archotol.1997.01900010076011
  13. Friel MT, Shaw RE, Trovato MJ, et al. The measure of face-lift patient satisfaction: the Owsley Facelift Satisfaction Survey with a long-term follow-up study. Plast Reconstr Surg 2010;126:245-57.
  14. Riefkohl R, Wolfe JA, Cox EB, et al. Association between cutaneous occlusive vascular disease, cigarette smoking, and skin slough after rhytidectomy. Plast Reconstr Surg 1986; 77:592-5. https://doi.org/10.1097/00006534-198604000-00013
  15. Parsa AA, Nakasone GK, Soon CW, et al. Smoking and breast reduction. Plast Reconstr Surg 2006;117:2506-7. https://doi.org/10.1097/01.prs.0000219996.34475.ca
  16. Baker DC, Stefani WA, Chiu ES. Reducing the incidence of hematoma requiring surgical evacuation following male rhytidectomy: a 30-year review of 985 cases. Plast Reconstr Surg 2005;116:1973-85. https://doi.org/10.1097/01.prs.0000191182.70617.e9
  17. Parsa FD, Parsa NN, Murariu D. Surgical correction of the frowning mouth. Plast Reconstr Surg 2010;125:667-76. https://doi.org/10.1097/PRS.0b013e3181c91d01
  18. Reiffel RS. Prevention of hypertrophic scars by long-term paper tape application. Plast Reconstr Surg 1995;96:1715-8. https://doi.org/10.1097/00006534-199512000-00031
  19. Atkinson JA, McKenna KT, Barnett AG, et al. A randomized, controlled trial to determine the efficacy of paper tape in preventing hypertrophic scar formation in surgical incisions that traverse Langer’s skin tension lines. Plast Reconstr Surg 2005;116:1648-56. https://doi.org/10.1097/01.prs.0000187147.73963.a5
  20. Henderson J, O’Neill T, Logan A. Direct anterior neck skin excision for cervicomental laxity. Aesthetic Plast Surg 2010; 34:299-305. https://doi.org/10.1007/s00266-009-9418-9
  21. Matarasso A, Elkwood A, Rankin M, et al. National plastic surgery survey: face lift techniques and complications. Plast Reconstr Surg 2000;106:1185-95. https://doi.org/10.1097/00006534-200010000-00033
  22. Thompson DP, Ashley FL. Face-lift complications: a study of 922 cases performed in a 6-year period. Plast Reconstr Surg 1978;61:40-9. https://doi.org/10.1097/00006534-197801000-00008

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