Are progressive tension sutures visible from the outside?

Question

I just read a review of drainless tummy tucks by a board certified plastic surgeon in my area who says she prefers traditional abdominoplasty (with drains) because the progressive tension sutures used for a drainless tummy tuck can be obviously and indefinitely visible from the outside. Is this accurate?

Gerald Minniti, MD, FACS · Answer

PTSs are more than just a space closer that negates the need for drains. They allow for tightening of the upper abdomen that you can't get without them in a traditional TT. When placing PTSs, tension is set and anchored at the top of the abdomen, breaking the 'big pull' of skin down into small, optimally tightened pieces that are locked in. When done correctly, seeing them afterward through the skin (permanently) will not happen. Many doctors resist because there is a steep learning curve, and even when surgeons become adept at them, they add 15 to 20 minutes to the procedure; time=money.  Make no mistake, PTSs have changed the level of results in the tummy tuck world.

Krishna Vyas, MD, PhD, MHS · Answer

To answer your question - no, when placed properly, these sutures should not be permanently visible. These sutures are placed on the inside from the skin to the abdominal wall to reduce the space and potential for fluid buildup/seroma.
Our meta-analysis (link below) revealed that a "drainless tummy tuck (abdominoplasty) with progressive tension sutures" was more effective than the traditional "tummy tuck with drains" in reducing seroma (fluid buildup) and reoperation rates, with no significant difference in hematomas or infections.
Though not all patients are ideal candidates for the drainless technique, it has proven to be a highly effective option. To ensure the best outcome, it's essential to consult with a plastic surgeon experienced in this technique. Incorrect placement of the sutures can lead to contour deformities or dimpling, and may require reoperation. Be sure to speak with a qualified surgeon to determine if a drainless tummy tuck is right for you!
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Kristopher Hamwi, MD · Answer

I suppose it is possible for a progressive tension suture to create an irregularity that is permanent but it is not particularly common. It is not uncommon for a stitch to create an irregularity initially but because the stitches are dissolvable as time goes on the irregularity goes away.

Martin Benjamin, MD, FACS · Answer

Hello! Progressive tension sutures (when placed correctly) should not be visible from the outside whatsoever after the healing process has taken place. Although you may see some "dimpling" in the early post operative phase, these always go away as the healing process progresses. It is a technically more challenging procedure and more time consuming which is why many plastic surgeons prefer the old traditional tummy tuck procedure. However my experience has been that patients who undergo drainless tummy tuck procedures recover much quicker and obtain much better results. Good luck!

Daniel Barrett, MD · Answer

Dear WildeMama7,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. Progressive tension suturing has changed tummy tuck surgery dramatically for the better. Better and low incisions with less tension and a significant decrease in seromas. The indents are very mild and temporary. I would look at a different surgeon. Every picture on my gallery is with PTS's. There are no indents. Best wishes to you.

Ronald J. Edelson, MD · Answer

Whether or not your surgeon uses drains is the last thing I would consider in choosing a surgeon. A lot of surgeons simply do the drain less  tummy tuck to appeal to is patients, not because it’s better.

Olivier Deigni, MD · Answer

Hello and thank you for your question. I perform drainless tummy tucks and have been doing so for many years. None of my patients have any visible sutures from the outside. I recommend you look at surgeons who perform the drainless tummy tuck and use progressive tension sutures so you can see the results.

Darryl J. Blinski, MD · Answer

Interesting question and observation. I am not a fan of the PTS TT. Yes, I personally have removed noticed sub cutaneous permanent sutures in very thin patients. So I am in full agreement with the PS you saw. If you are thin layered abdominal fat the chances of noticeable PTS sutures is 50%. Also why not use a drain or drains (only costs $50!) to prevent seroma formation even in a PTS TT??

Are progressive tension sutures visible from the outside?

Answers (9)

More Drainless Tummy Tuck Questions

Upper abdomen pain 6 months after extended tummy tuck. What could this be?

Ingrown hairs and tummy tuck in women of color?

Muffin top, hanging belly, and loose skin - Do I need a tummy tuck revision? (photos)

Stomach is wrinkly after each pregnancy - what procedures would I need for this? (photos)

Hernia after tummy tuck? (Photo)

WE SEND PRETTY
EMAILS