title: Micro-Shuttle Lifting of the Neck: A Percutaneous Loop Suspension Method Using a Novel Double-Ended Needle.
abstract: BACKGROUND
  Most younger patients expect to be able to achieve significant improvements and lift to their neck, yet they don't want to undergo extensive surgery. They are now able to do that and restore their youthful appearance thanks to new concepts the techniques through volume redistribution.
  
  
  OBJECTIVE
  The authors' goal was to achieve results that are comparable to a necklift and durable through minimally invasive surgery, utilizing punctures instead of incisions.
  
  
  METHODS
  The concept of micro-shuttle lifting creates a percutaneous hammock to achieve the lifting of all different planes of the neck at once. This is accomplished by putting nonabsorbable sutures on nonundermined platsyma through the use of a double-ended (micro-shuttle) needle and anchoring it to fixed thread loops around the ears. Mitigation of gravitational force is accomplished through the loop suspensions, to obtain effective skin redraping over the suture-created internal splint.
  
  
  RESULTS
  This combined technique for the neck was applied in 221 selected patients between December 2005 and May 2014, with follow-up ranging from 8 months to 7 years. The mean age of the patients was 42.5 years. Outcomes were satisfactory in all but 12 cases, of which 7 found the result inadequate. The operation time for the neck was less than 40 minutes under local anesthesia or local anesthesia with sedation, and the recovery time was 5-7 days.
  
  
  CONCLUSIONS
  The sustainability of this percutaneous procedure does not rely on the suspensions, but rather on the skin redraping in the new position in a similar manner to orthopedic fracture treatment. In selected patients, this safe and simple percutaneous necklifting method can be quickly and easily performed under local anesthesia with long-term durability, low morbidity, and a high patient satisfaction rate. LEVEL OF EVIDENCE 4: Therapeutic.
authors.affiliation: Drs Tiryaki and Aksungur are plastic surgeons in private practice in Istanbul, Turkey. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; a Clinical Professor, Division of Plastic and Reconstructive Surgery, University of Wisconsin, Madison, WI; and is the CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: Kemal Tunc
authors.initials: KT
authors.lastname: Tiryaki
authors.affiliation: Drs Tiryaki and Aksungur are plastic surgeons in private practice in Istanbul, Turkey. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; a Clinical Professor, Division of Plastic and Reconstructive Surgery, University of Wisconsin, Madison, WI; and is the CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: Esin
authors.initials: E
authors.lastname: Aksungur
authors.affiliation: Drs Tiryaki and Aksungur are plastic surgeons in private practice in Istanbul, Turkey. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; a Clinical Professor, Division of Plastic and Reconstructive Surgery, University of Wisconsin, Madison, WI; and is the CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: James C
authors.initials: JC
authors.lastname: Grotting
mesh_terms: D000328:Adult; D000772:Anesthesia, Local / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009333:Neck; D009339:Needles; D017060:Patient Satisfaction; D012060:Rejuvenation; D015361:Rhytidoplasty / Q000379:methods*; D015595:Skin Aging; D013536:Suture Techniques