Do progressive tension sutures really decrease complications and result in better scars in tummy tuck surgery?

Hello, some time ago I transitioned to using progressive tension sutures for most cases, with the goal of closing the abdominal wound space and not needing to insert drains.  I have been extremely pleased with the results and rarely do the procedure the previous way.  That stated, I also had good outcomes when drains were used.  I was simply worried about drain site infections, and my patients found them inconvenient.  Even when progressive tension sutures are used bleeding, seroma (fluid collections), and poor scars can occur so no operation can completely eliminate these problems.  Overall I do prefer the progressive tension suture / "drainless tummy tuck" operation.

Thank you for your question. I do not believe progressive tension sutures and have any long-term benefit for patients. The only short-term benefit is elimination of drains doing the procedure.  I only perform this technique when specifically requested. I do explain to patients that edema and swelling in the persists longer than when drains are used. 

Techniques for abdominoplasty vary among surgeons, depending on their training and experience.  If progressive tension suturing consistently provided patients with better results, then every plastic surgeon would use it.  I believe that in the right hands, either technique can provide patients with very good results.   You are correct in that there are no studies that overwhelmingly demonstrate that one particular technique is superior.  My suggestion is to discuss your concerns with each surgeon.  You can also review the results of other patients that they have operated on.  I would go with the surgeon that you feel most comfortable with, and not base your decision on the technical aspects of the procedure.

Hello cas1936 and thanks for your question. There's no way to make the appropriate diagnosis online and to give you a recommendation without an examination. So this is just a guess. My personal experience is that PTS helps in most cases of tummy tuck to make the operation go better at least in my practice. The advantages are better results, reasonable scars and less seroma. This is my experience and it does not mean your operation or your chosen surgeon will have less complications. Be sure you choose a surgeon certified by the American Board of Plastic Surgery. Best, Dr. ALDO.

Thank you for your question. The progressive suture technique only decreases the need for drains postoperatively. It does not give better results or better scarring.  Tummy tuck  results are based on your surgeons experience and expertise in this field. I recommend finding one who is board certified and a member of the American Society of aesthetic plastic surgeons.

Thank you for your question.  Like many things in plastic surgery, there are different ways to achieve a good result.  The abdominoplasty procedure has been done without progressive tension sutures for many years with excellent results.  The premise of using progressive tension sutures are 2 fold: first it functions to decrease dead space into which a fluid collection (either hematoma or seroma) can collect; Second, it serves to decrease the amount of tension on the final skin closure by distributing the tension along the full length of the abdomen.  Thus, progressive tension sutures, in theory, allow for the elimination of drains and for decreased tension on closure, which does result in improved healing and scaring at the skin.  I use progressive tension sutures and have been happy with the results.  I would recommend discussing your concerns with your potential surgeons and going with your gut feeling.  In the end, you need to be comfortable with the proposed procedure and your surgeon. 

Thank you for the question. It is extremely common to receive different opinions from different plastic surgeons about the best way to treat a specific “problem”. Each plastic surgeon may have his/her opinion that is based on their specific/unique education, experience, and personal preferences. Their opinions may also be shaped by unfavorable results they have encountered in their practices.Although these different opinions can be confusing and a source of anxiety for patients, it is good for patients to understand the different options available. Ultimately, it will be up to each patient to do their due diligence and select their plastic surgeon. Part of this selection process will involve the patients becoming comfortable with the plastic surgeon's experience level and abilities to achieve their goals as safely and complication free as possible. In my practice, I use progressive tension sutures for most patients. I cannot prove that the use of this technique results in improvement of scars (although this is my impression). I hope this, and the attached link, helps. Best wishes.