Tie Retraction Syndrome? Fat chance

Every now and then, we’re accused of “gotcha journalism” here at Retraction Watch. But here’s the story of a paper that we hope you’ll agree is “gotcha” science of the best kind, involving a different kind of retraction. The research is of, shall we say, a pressing problem known as Tie Retraction Syndrome, or TRS for short, brought to the world’s attention by a group of ophthalmologists in Germany and the UK.

According to the paper in Orbit, TRS is:

…a slowly progressive pseudovertical shortening of tie length due to a horizontal extension of girth length. Other pathognomonic features include an increased tie tip to belt buckle distance and a prolapse of the subumbilical fat pad (SUFP). The syndrome has a clear male to female preponderance and shows an increasing incidence with age and income before tax. Based on a newly proposed grading scheme we discuss and illustrate the diagnosis as well as the medical and surgical management options of this abundant, but often undiagnosed condition.

You can see for yourself just how debilitating the condition can be, in this figure from the paper:

FIGURE 1 Normal Tie Tip To Belt relation (1A) and grades I to IV (1B-E) and “Plus” disease (1F) of the TRS.

Talk about a stuffed shirt! The paper offers some helpful tips on how to treat TRS:

Prophylactic measures include a change of dress style from wearing a tie to cravat or preferably bow tie. Reducing trunk height can be considered, but may also occur spontaneously with increasing age and crush fractures of the vertebrae. Treatment can be conservative (medical) or surgical. Medical options include laxatives as well as dietary and nutritional control to reduce “d´.” Although potentially very effective these measures are often not well tolerated by the individual affected, with consequent poor compliance with the treatment regime.

Of course, there are various tie lengthening procedures, tie recessing procedures, and belt raising procedures. And then there are more drastic measures:

Although decompression of the lateral abdominal walls has been advocated, for optimal functional and aesthetic outcome ablation of the subumbilical fat pad is mandatory. This can be attempted via an external approach using a 193 nm Excimer laser with masking substances in order to achieve an optimal smooth surface, with little or no spherical aberration.

Like all helpful papers, this one offers some alternative explanations for the findings:

Since the Tie Retraction Syndrome was first observed in the late 1990s, there has been a change in dress style in the United Kingdom throughout all levels of society, but particularly in previously protected areas such as NHS hospitals, in which tie usage was particularly preponderant. This coincided with a ban on wearing ties introduced in the guise of the “Bare Below the Elbows” policy apparently claiming to reduce infection risk. Despite the lack of published epidemiological evidence there appears to be a direct correlation between the introduction of this directive and the incidence and even prevalence of tie retraction. Population based studies are currently under way in order to confirm level 1 evidence, i.e., expert opinion, which suggests that there has been a sharp rise in the incidence of bow tie and cravat wearing in the NHS. Tie retraction in its purest form is thus (in the medical species) only seen now in private hospitals in the United Kingdom, where this interesting and fascinating Syndrome is still very abundant.

The study was funded, in part, by the European Society for Circumferentially Challenged Ophthalmic Plastic Reconstructive Surgeons (ESCCORPS). This group, of course, does not exist. Neither does the “Neppert” Formula, used to grade the severity of TRS and conveniently named for middle author Birte Neppert. But if these researchers are circumferentially challenged, they don’t seem to be comedically challenged.