With a tummy tuck, are progressive tension sutures permanent or dissolvable?

Progressive tension sutures are typically dissolvable. They are sometimes referred to as quilting sutures and act to reattach the fat layer to the muscle layer after a tummy tuck. They are generally used to take tension off of the lower incision as it heals and reduce the chances of developing a fluid collection called a seroma. Once you have recovered from the procedure you don't need them anymore so plastic surgeons tend to use an absorbable suture. They may cause an indentation in the skin immediately after the procedure but it goes away as they dissolve and it will not impact the final results even iff you gain or loose weight.

I only use progressive tension sutures that are dissolvable (I assume most surgeons would do the same).
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.
Despite these findings, many plastic surgeons continue to use drains during tummy tucks (typically since they were trained to use drains and continue this standard practice). Drains are typically used to prevent fluid accumulation under the skin, a common issue after the procedure. Fluid buildup, known as a seroma, can slow the healing process and lead to complications. Drains help remove this fluid, ensuring proper healing and minimizing complications. However, drains can be uncomfortable, require extra care, and increase the risk of infection at the insertion points. They can also leave scars, even after removal.
The introduction of the "drainless" tummy tuck, typically performed with progressive tension sutures, offers a promising alternative. These sutures close any dead space in the skin flap, significantly reducing fluid buildup and seromas. This technique eliminates the need for drains, which can lead to faster recovery times and less post-operative discomfort. While effective, this method has some challenges, such as a slightly longer surgical time and the need for a skilled and experienced surgeon. Some surgeons may still opt for drains, particularly in patients with certain body types or those undergoing significant liposuction, due to concerns about fluid accumulation. However, as evidence supporting the benefits of drainless tummy tucks continues to grow, this approach is gaining popularity for its improved patient comfort and smoother recovery process.
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

Great question, these sutures dissolve. I’m not sure there’s a single surgeon who would use permanent sutures for this aspect of the surgery. It is rare that we use permanent sutures anymore for a TT.