Is using staples to close a tummy tuck a good/normal practice?

Question

Hi there, please may i have some advice. I have had a consultation with my surgeon of choice but he has told me that he uses staples to close a TT? Is this good/normal practice? Frankly I hate the idea anddits putting me off using him. What do you think?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether it's normal to use stables during a tummy tuck. I am a board-certified plastic surgeon and do NOT use staples for a tummy tuck. In my opinion, a tummy tuck is usually an elective cosmetic procedure. Since it is an elective cosmetic procedure, you want it to look as good as possible. Therefore, the best scar is achieved with sutures, not staples. Staples, as you probably know, leave track marks and suboptimal scars. Therefore, it is not common practice to use staples for a tummy tuck. Thank you for your question regarding whether it's normal to use stables during a tummy tuck.

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Aftab Siddiqui, FRCS(Plast) · Answer

I can not comment on other surgeons practice and results, i prefer all dissolving sutures in tummy tuck to give goos results , the sutures can take weeks to dissolve and scars will settle down in few months time.

Gary M. Horndeski, MD · Answer

Most plastic surgeons do not use staples to close a tummy tuck as it leaves unsightly scars such at staple tracks.  I recommend a subcuticular closure with slowly absorbable sutures.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

There are a lot of plastic surgeons who use staples. Even on facelifts if you can believe it. My personal opinion is that it’s sloppy and can leave permanent marks from the staples. But it’s much more common than you would think

Daniel Barrett, MD · Answer

Dear Intuitive820610,
scar prevention begins in the OR during the surgery when I meticulously close wounds in multiple layers in order to reduce tension and reduce scars width. I tape my incisions during the early postoperative period to reduce micromotions of the tissues so the incision can heal earlier. I also use compression garments and later Biocorneum gel.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jeremy S. Hurren, BSc, MBBS, FRCS (Plast) · Answer

There are different types of staples. It is quite common practice to use dissolving skin clips (which could be described as staples) under the skin where they can not be seen. They then dissolve in the weeks after surgery. Mental staples to hold the skin together for a standard abdominoplasty is not something I would use (except in an emergency to bring an operation to an end in an emergency, like if the hospital is on fire and we need evacuate!!! so far I have never had to do this!). I and I think most surgeon would use a dissolving running stitch under the skin called a subcuticular suture for a standard abdominoplasty. These do not need to be removed. Metal skin staples need to be removed, are uncomfortable and frequently leave marks on the skin as dots down either side of the scar.I suggest you clarify if the surgeon means metal staples in the skin and if they do then enquire as to why they do not use a subcuticular suture.Best wishes.

Reza Alamouti, MD, FRCS · Answer

HelloThank you for the question,Using staples is one way of closing a wound however most plastic surgeons prefer to use dissolvable sutures running under the skin.Best wishes

Camille Cash, MD · Answer

While staples can be used to close a tummy tuck incision, they are less common than regular suturing.  Staples can leave permanent marks and are sometimes painful to remove.  I encourage you to discuss your concerns with your surgeon.

Paul Drake, MBChB · Answer

Staples can provide adequate wound closure, but they leave little dots along the scar which are often permanent. They are also quite painful to remove. I and most of my colleagues prefer an absorbable suture under the skin (called a subcuticular suture) which avoids external suture marks and doesn't require removal. Occasionally suture knots can be problematic and appear through the wound, but this is a fairly minor problem.
Hope this is helpful

Mats Hagstrom, MD (license on probation) · Answer

The only time plastic surgeons use staples are in the scalp where they are preferred and have an advantage or when the appearance of the scar doesn’t matter.

Staples can expedite the closure of skin wounds and reduces operating and anesthesia time to some degree.

On a massive weight loss case doing a Wraparound tummy tuck combined with arm lifts the total length of the incision may be 10 feet long.

For an  individual surgeon to hand sow this versus using Staples may save an hour and a half of operating time.

Patients who want to have the least visible scars are entitled to have plastics surgeons full attention and deserved a closure done with buried absorbable sutures.

Staples will not leave “staple” scars if removed in less than eight days but that is usually insufficient for wound strength and most surgeons will leave staples in for closer to two weeks.

Now you know the opinion of one plastic surgeon and learned a little bit more about how he practices medicine.

You can use that for reference for your next consultation.

I recommend anyone considering cosmetic surgery have multiple in person consultations before choosing a provider.

During consultations I encourage patients to ask providers to show their entire collection of before and after pictures. Seeing a handful of selected results which in fact represent the best results of the providers career is insufficient to get a clear understanding of what average results look like.  it is also insufficient to get any confirmation of how many procedures the surgeon has performed unless he or she acknowledges the only done a few.

And experience provider should have no difficulty showing you 50 or more sets of before and after pictures for a tummy tuck.

Asked the provider to find pictures of patients with very similar characteristics to your own.

When judging outcomes look carefully at who gets the most natural looking belly buttons.

This together with a very low set scars that naturally follows an atomic contour and delivers an attractive body seen from all angles is the hallmark of quality work.

I recommend reading all reviews on various physician review websites and avoiding providers for than a significant number of justified negative reviews.

The absence of justified negative reviews is more important and more telling than an abundance of positive reviews.

When in doubt continue scheduling more consultations.

This procedure is permanent and irreversible.

If not done correctly they are very difficult to revise.

Good luck,

Mats Hagstrom, MD

Is using staples to close a tummy tuck a good/normal practice?

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