The male neck and T-Z-plasty: 28 years later

Abstract

Background: Many men seek treatment for excess submental tissue—the so-called “turkey gobbler” deformity. However, these patients are frequently unwilling to undergo the definitive treatment, a rhytidectomy and platysmaplasty with submental lipectomy. Objective: The purpose of this article is to present an update on an alternative treatment, originally reported in 1971, called the T-Z-plasty. Methods: The procedure, which is performed with the patient under local anesthesia, entails excision of excess fat and skin, tightening of the platysma, a Z-plasty to prevent contracture, and wound closure with excision of redundant skin. Results: In a series of more than 100 patients, the results have been consistently superior with extremely low morbidity. There was 1 postoperative hematoma requiring exploration and, in the same patient, a subsequent seroma requiring multiple aspirations. In addition, 2 patients required scar revision. Conclusions: The T-Z-plasty is a simple outpatient procedure with consistently low morbidity and high rates of patient satisfaction. Although the procedure does not offer the same result as the definitive treatment, rhytidectomy and platysmaplasty, it is a reasonable compromise that directly and effectively addresses the primary complaint.