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

Are progressive tension sutures visible from the outside?

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Answer: Tension sutures

Answer: Tension sutures

Answer: Progressive tension sutures

Answer: Progressive tension sutures

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Are progressive tension sutures visible from the outside?

Answers (9)

Answer: Tension sutures

Answer: Tension sutures

Answer: Progressive tension sutures

Answer: Progressive tension sutures

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Recommended reading

Everything you need to know about Drainless Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.