The percutaneous trampoline platysmaplasty: technique and experience with 105 consecutive patients.
BACKGROUND
Controversy persists regarding the optimal procedure to rejuvenate the aging neck. More invasive procedures carry increased risks of complications, whereas less invasive approaches may deliver marginal results. The challenge is selecting the appropriate procedure for delivering consistent, durable results meeting both the patient's and surgeon's expectations.


OBJECTIVE
The authors describe their trampoline platysmaplasty (TPP) approach, a percutaneous suture suspension necklift that constitutes a less invasive approach for neck rejuvenation.


METHODS
A retrospective study was conducted of 105 consecutive patients who underwent TPP. Age, sex, procedure(s) performed, complications, and patient satisfaction were recorded. Cadaver studies were conducted to compare the tensile strength of the ligaments that anchor the TPP to the tensile strength of the sutures placed to approximate the medial platysma borders. In addition, the accuracy of light transillumination to determine depth of travel of the light-emitting diode (LED) lighted rod was evaluated.


RESULTS
Patients underwent either TPP alone (18 women, 24 men) or TPP with a facelift (35 women, 28 men) between October 2007 and June 2009. The average age of the patients was 52 years, and average length of follow-up was 33 months. Patient satisfaction was high. Three early patients underwent immediate revision to improve results secondary to the suture matrix being too loose. Six additional patients had recurrent banding around one year postoperatively, but correction was achieved in all six by replacing the matrix with the help of the lighted rod. The results of the cadaver study revealed that the tensile strength of the retaining ligaments was statistically identical to the medial platysma borders, and the light transillumination feedback was accurate with regard to the depth of travel of the illuminated rod tip.


CONCLUSIONS
The TPP approach for neck rejuvenation is effective and durable in properly-selected patients. It works well as a stand-alone procedure and in conjunction with facelift procedures. It also offers younger patients a less-invasive option to improve neck contours inherited through genetics. After nearly three years of follow-up of the patients in this report, the results appear to be long-lasting.
Division of Plastic and Reconstructive Surgery, UCLA School of Medicine, Los Angeles, California, USA. greg.mdgpm@gmail.com
Gregory P
GP
Mueller
Norman
N
Leaf
Sherrell J
SJ
Aston
Corbett W
CW
Stone
D000375:Aging / Q000502:physiology*; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009334:Neck Muscles / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012060:Rejuvenation; D015361:Rhytidoplasty / Q000379:methods; D013536:Suture Techniques; D013718:Tensile Strength; D016896:Treatment Outcome