American Society of Plastic Surgeons
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D DeByl
3 years ago
Answered

T-Z Plasty

What is this procedure and wharom are the typical body applications? Is it effective for neck lifts?

Procedure: Facelift

Replies 4

Jonathan Zelken
ASPS Surgeon
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Interesting... I have never heard of a T-Z plasty, but that most certainly does not mean it doesn't exist. I have heard of O-Z plasty, however, and know it can be used for skin excision in a neck lift. There are many elegant little flaps for direct neck lifts, but I find myself doing a straight-line closure more an more. Depending on your goals, expectations, and anatomy, sometimes simpler is better. An in-person exam with any ASPS member (implies board certification) may steer you in the right direction. But all these little flaps are artfully designed so there is no one-size-fits-all answer.

I hope this helps,

Jonathan Zelken MD

Zelken Institute - Newport Beach

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Michael Kulick
ASPS Surgeon
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I like others am confused with your terminology. A "Z" pasty can be performed as w way to directly reduce neck skin laxity. I suggest you consult with a board certified pasty surgeon to help you with your concerns.

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Jon Ver Halen
ASPS Surgeon
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Dear D DeByl,

Hello and thank you for your excellent question. Like the other surgeons on this thread, I can only offer an educated guess to your question without an in-person consultation. If patients have a lot of excess neck skin, sometimes it is necessary to cut it out from the central portion of the neck (instead of removing it only from the sides). In these cases, sometimes we convert that "T" incision into a "Z" incision to 1) make a less visible scar, 2) obtain a better aesthetic result, and 3) prevent late scar contractures. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!

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Gregory Dowbak
ASPS Surgeon

I know this flap and have used it a lot doing neck lifts. It was first published in the Journal of the American Society of Plastic Surgeons (the “White Journal”) in 2007 (?) by Dr Timothy Miller. I have never called it the T-Z flap as it is slightly misleading as a T is not converted to a Z. Rather a T incision is made in submentum and sub platysmal fat excised and double layer platysmal tightening done. For patients with a lot of excessive skin, a large Z Plasty is performed on the long arm of the T. This creates a beautiful contour of neck that is precise. The BIG advantage of this procedure is avoiding a scar around the ear, thus exceptionally useful in men. Any raised reddened scar post op can be “erased” (I mean it) with Dornier 940 Diode Laser, one treatment only. Look for a member of this Society that also has an active medical spa which uses lasers in your area. I have always been surprised why more surgeons do not use this techniqud.

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