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Revisiting The T-Z-Plasty: Modified Approach And Broadened Indications
Peter Zak, MD
1,
Tanir A. Moreno, MD2, Alexa De La Fuente Hagopian, MD
1, Matthew Williams, MD
1, Jeffrey D. Friedman, MD
1.
1Houston Methodist Institute for Reconstructive Surgery, Houston, TX, USA,
2Baylor College of Medicine Division of Plastic Surgery, Houston, TX, USA.
PURPOSE: The T-Z-plasty, first introduced in 1971 by Drs. Biggs and Cronin, was designed to correct the "turkey gobbler" neck in men, but its application in women has been limited. This study presents our modifications to the original technique and advocates for its use in men as well as in select female patients.
METHODS: A retrospective review of patients who underwent a modified T-Z-plasty by the senior author from 2002 to 2024 was conducted. Indications for women included unsuitable candidacy for standard rhytidectomy, previous complications from rhytidectomy, or preference for a shorter, quicker recovery. Our modifications involve a smaller Z-plasty with 1 cm limbs to disrupt vertical scarring and prevent anterior neck tightness. Additionally, the inferior extent of the incision was extended to include the entirety of the skin excess rather than limiting it to above the thyroid cartilage.
RESULTS: The study included 8 females and 34 males. Mean operative time was 116.3 minutes. Complications were minimal, with one case of hypertrophic scar (2.4%) and one instance of partial wound dehiscence (2.4%). Overall patient satisfaction was high.
CONCLUSION: Our modified T-Z-plasty technique demonstrates acceptable scarring, reproducible outcomes, minimal complications, rapid recovery, and high patient satisfaction. This approach provides an effective alternative for both male and female patients seeking correction of significant neck laxity or deformity without complaints of facial aging.
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