Progressive Tension Suturing with Abdominoplasty?

I had a 9-month follow-up appt with my PS today (brachio and breast lift last November).

I briefly asked him about the excess skin on my upper abdomen ---- and he told me that he uses the Progressive Tension Suturing technique --- drainless and typically done in at the Outpatient Surgical center.

He places a thin catheter with a type of novacaine that keeps the area numb and reduces the need for extended pain medication.

I have an in-depth consult with him in November (my husband and I are hiking into and out of the Grand Canyon in late October -- so no surgical decisions before that time) when I go back for my final follow up appt.

I am curious to speak with others who have had a TT using this approach.

thanks!
Kath

I've never heard of that. Sorry!! But then again, I know my surgeon is the best of the best, so I did not ask many questions. It sounds impressive, though. Good luck!!

Laura

Progressive Tension Suturing (PST) gets kind of mixed reviews among surgeons. I've tried it a number of times on small tummy tucks on non bariatric patients (where it should work the best) but my seroma rate skyrocketed and I went back to placing a small drain for a few days and have been much happier not having patients back weekly for seroma drainage.. When you do PTS, you typically have to do a limited undermining type of procedure and a lot of liposuction which is the opposite of what many (most) weight loss patients need (ie. aggressive resection of loose skin). If you look at the surgery literature on PTS, almost none of it is talking about weight loss patients and most of the photos are on smaller frame patients. . If you're a more tiny framed and "normal" shaped and appearing lap-band or self directed weight loss, maybe I could imagine a few people you could think about it.

Generally speaking, most weight loss patients would not be candidates for trying PTS on an abdominoplasty or panniculectomy case as the expected seroma rate would be sky high. Weight loss patients wounds behave significantly different in terms of fluid egress and PTS has no concievable advantage to me for that particular operation.

In contrast, I rarely drain brachioplasty procedures anymore as you don't get much of a seroma problem there. Thigh lifts I've gone back to draining. For breasts it depends on what type of mastopexy or reduction I do (larger or more traditional procedures get a drain, while lifts with an implant don't most of the time).