Demand for short recovery and less invasive correction for moderate skin and soft tissue neck laxity is increasing, especially among younger patients. The current study aims to evaluate the feasibility of a short recovery and minimally invasive technique of polytetrafluoroethylene (PTFE) bands and minimal skin excision for moderate platysma and skin laxity.
Following periauricular incision, PTFE bands of dual mesh are customized for suture to the platysma and anchored to the mastoid, creating a neck artificial ligament (NAL). NAL is buried into the muscle and tightened, without modifying the superficial musculoaponeurotic system and platysma. Young patients with moderate platysma and skin laxity were enrolled. Outcome was measured in terms of complications, recovery time, and patient and clinician satisfaction (1 = very dissatisfied, 2 = dissatisfied, 3 = satisfied, and 4 = very satisfied).
A population of 107 consecutive patients (94% female) was treated, January 2013–January 2017. Average patient age was 51 years (46–56). Complications were rare: 1 case of superficial epidermolysis (healed within 21 days) and 1 case of mild band infection (treated with antibiotics). At a mean follow-up of 16 months, average patient and clinician evaluations were satisfactory (average satisfaction: patient 3.2, clinician 3.1).
In young patients with moderate platysma and skin laxity, minimally invasive NAL avoids deep modifications of the superficial musculoaponeurotic system and platysma. Despite the relative short follow-up of this study, the low rate of complications, short recovery time, and acceptable patient and clinician satisfaction seem promising.
Level of Evidence: Level IV, therapeutic study.
This is a preview of subscription content, log in to check access.
Buy single article
Instant unlimited access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Fitzgerald R, Graivier MH, Kane M Lorenc P, Vleggaar D, Werschler P, Kenkel JM (2010) Update on facial aging. Aesthet Surg J 30:11S–24S
Henderson J, O’Neill T (2010) Direct anterior neck skin excision for cervicomental laxity. Aesthetic Plast Surg 34:299–305
Cronin TD, Biggs TM (1971) The T–Z-plasty for the male “turkey gobbler” neck. Plast Reconstr Surg 47:534–538
Parsa FD, Castel N, Parsa NN (2016) A modified, direct neck lift technique: the cervical wave-plasty. Arch Plast Surg 43:181–188
Coleman SR (1997) Facial recontouring with lipostructure. Clin Plast Surg 24:347–367
Tiryaki KT, Aksungur E, Grotting JC (2016) Micro-shuttle lifting of the neck: a percutaneous loop suspension method using a novel double-ended needle. Aesthet Surg J 36:629–638
Fabi SG (2015) Noninvasive skin tightening: focus on new ultrasound techniques. Clin Cosmet Investig Dermatol 8:47–52
Fabi SG, Goldman MP, Mills DC, Werschler WP, Green JB, Kaufman J, Weiss RA, Hornfeldt CS (2016) Combining microfocused ultrasound with botulinum toxin and temporary and semi-permanent dermal fillers: safety and current use. Dermatol Surg 42:S168–S176
Atiyeh BS, Dibo SA, Costagliola M, Hayek SN (2010) Barbed sutures “lunch time” lifting: evidence-based efficacy. J Cosmet Dermatol 9:132–141
Paul MD (2008) Barbed sutures for aesthetic facial plastic surgery: indications and techniques. Clin Plast Surg 35:451–461
Gonzalez R (2009) Composite platysmaplasty and closed percutaneous platysma Myotomy: a simple way to treat deformities of the neck caused by aging. Aesthet Surg J 29:344–354
Pontes R (1991) Extended dissection of the mental area in face-lift operations. Ann Plast Surg 27:439–456
Narasimhan K, Ramanadham S, O’Reilly E (2016) Secondary neck lift and the importance of midline platysmaplasty: review of 101 cases. Plast Reconstr Surg 137:667e–675e
Matarasso A (2014) Managing the components of the aging neck: form liposuction to submentalplasty, to neck lift. Clin Plast Surg 41:85–98
Auersvald A, Auersvald LA, Oscar Uebel C (2017) Subplatysmal necklift: a retrospective analysis of 504 patients. Aesthet Surg J 37:1–11
Conrad K, Chapnik JS, Reifen E (1993) E-PTFE (Gore-Tex) suspension cervical facial rhytidectomy. Arch Otolaryngol Head Neck Surg 119:694–698
Prabhat A, Dyer WK (2003) Improving surgery on the aging neck with an adjustable expanded polytetrafluoroethylene cervical sling. Arch Facial Plast Surg 5:491–501
Hector G, Silva L (2016) Facial laxity scale validation study. Dermatol Surg 42:1370–1379
Sanniec KJ, Velazco CS, Macias LH, Zuhlke TA, Casey WJ, Leighton WD, Mahabir RC, Rebecca AM (2016) Adherence to photographic standards: a review of ASPS and ASAPS member surgeons’ websites. J Aesthet Reconstr Surg 2:1–7
Bernardini FP, Gennai A, Izzo L, Devoto MH (2013) Minimal incisions vertical endoscopic lifting and fat grafting as a systematic approach to the rejuvenation of the periocular esthetic unit. Ophthalmic Plast Reconstr Surg 29:308–315
Bernardini FP, Gennai A, Izzo L, Zambelli A, Repaci E, Baldelli I, Fraternali-Orcioni G, Hartstein ME, Santi PL, Quarto R (2015) Superficial enhanced fluid fat injection (SEFFI) to correct volume defects and skin aging of the face and periocular region. Aesthet Surg J 35:504–515
Gennai A, Zambelli A, Repaci E et al (2017) Skin rejuvenation and volume enhancement with the micro superficial enhanced fluid fat injection (M-SEFFI) for skin aging of the periocular and perioral regions. Aesthet Surg J 37:14–23
Antell DE, May JM, Bonnano MJ, Lee NY (2016) A comparison of the full and short-scar face-lift incision techniques in multiple sets of identical twins. Plast Reconstr Surg 137:1707–1714
De Benito J, Righesso R (2007) Surgical treatment of cervical region associated with polytetrafluoroethylene platysmal suspension sutures. Rev Soc Bras Cir Plast 22:202–208
Kim JM, Jang YJ, Kwon BS, Arakaki M, Hong SJ (2010) Lower face-lift with expanded polytetrafluoroethylene superficial musculoaponeurotic system extension graft (Bandlift Implant). J Craniofac Surg 21:1928–1931
Mole B (1992) The use of Gore-Tex implants in aesthetic surgery of the face. Plast Reconstr Surg 90:200–206
Owsley TD, Taylor CO (1994) The use of Gore-Tex for nasal augmentation: a retrospective analysis of 106 patients. Plast Reconstr Surg 94:241–248
Niamtu J (2005) Advanta facial implants. Oral Maxillofac Surg Clin North Am 17:29–39
Linder RM (1992) Permanent lip augmentation employing polytetrafluoroethylene grafts. Plast Reconstr Surg 90:1083–1090
The authors would like to thank Johanna Chester for her constructive criticism and editing of the manuscript.
The authors received no financial support for the research, authorship, and publication of this article.
Conflict of interest
Alessandro Gennai and Giorgio d’Angelo declare that they have no conflict of interest.
All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.
About this article
Cite this article
Gennai, A., d’Angelo, G. Minimally invasive neck rejuvenation of moderate cervicomental laxity with polytetrafuoroethylene (PTFE) bands. Eur J Plast Surg 41, 625–636 (2018) doi:10.1007/s00238-018-1428-x
- Platysma muscle