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Surgical Technique |

Direct Excision of the Turkey Jowl Deformity A Review of 100 Consecutive Cases

William H. Lindsey, MD; Philip E. Zapanta, MD
Arch Facial Plast Surg. 2007;9(1):56-61. doi:10.1001/archfaci.9.1.56.
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Objective  The aging of the neck is a combination of accumulated submental fat, platysmal banding, and redundant skin. Traditional face- and neck-lifting procedures successfully address these components. Unfortunately, the cost, both in terms of downtime and expense, often becomes prohibitive for a large section of the interested patient population. For select male patients, direct excision of the turkey jowl deformity with a straight-line closure offers a novel alternative.

Design  A review of 100 consecutive cases of direct excision of turkey jowl deformity procedures was performed. Minimal follow-up was 1 year. All surgical procedures were performed in the office setting with local anesthesia.

Results  Eight patients had extrusions of suture without recurrence of banding. Four patients required steroid injections for mild scar hypertrophy; 2 of these patients requested minor scar revisions 1 year later. There were no cases of postoperative bleeding, infection, or nerve injury. All 100 patients were satisfied with the overall cosmesis, and none had revision jowl surgery.

Conclusions  Direct excision of the turkey jowl with a straight-line closure offers a major improvement in the aging neck with minimal downtime, expense, and complication rate. This procedure can be easily accomplished and safely performed in an office environment.

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Figures

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Figure 1.

The turkey gobbler neck.

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Figure 2.

The incision is placed to save as much skin as possible and to limit skin tension on closure. The arrows mark the widest point of the excised area corresponding to the area of highest skin tension.

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Figure 3.

Technique of removing the excess skin and adipose tissue. A, The skin ellipse is removed sharply (in the foreground is the surgeon’s hand with tweezers holding the removed skin flap). B, Excess periplatysma adipose tissue is removed sharply. Insets, The respective amount of removed tissues.

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Figure 4.

The platysma. A, The nondecussating platysma fibers. B, Horizontal mattress sutures plicate the platysma.

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Figure 5.

The distribution of skin tension at closure. A, The point of maximal skin tension during the subcutaneous closure. B, The last layer of skin closure.

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Figure 6.

Immediate postoperative results.

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Figure 7.

Long-term results (15 months after surgery). A, Frontal view, before and after surgery; B, lateral view, before and after surgery.

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