Expanding the Progressive Tension Suture Concept: A Study of Its Utility in Body Contouring Procedures

BACKGROUND: Seroma is one of the most common complications following body contouring. Progressive tension sutures (PTSs) have been shown to decrease the seroma rate following abdominoplasty, component separation, and facelifts and following latissimus flap and deep inferior epigastric artery perforator flap harvest. OBJECTIVES: The aim of this study was to investigate the effects of PTS techniques and their impact on the seroma rate in body contouring flap procedures. METHODS: A retrospective review was performed of all patients undergoing a flap procedure (defined as any procedure that produces a dead space and subsequent susceptibility to seroma) by a single surgeon at a single institution over 3 years. All patients/procedures utilized PTS techniques, as is routine in the surgeon's practice. No drains were used. Patient demographics and complications, including seroma, were tracked. RESULTS: A total of 441 flap procedures were performed in 351 patients over the 3-year study period. These procedures comprised 305 abdominoplasties, 68 lower body lifts, 17 medial thigh lifts, 36 brachioplasties, and 15 torsoplasties. PTSs were used in all procedures. No drains were utilized. Complications occurred in 72 procedures (16.3%), with the most common complication being minor wound dehiscence without infection. There were no cases of seroma. CONCLUSIONS: PTSs represent an effective technique for reducing the seroma rate, eliminating the potential space and promoting tissue adherence in flap procedures for body contouring. This is the first study of its kind demonstrating the use and role of this technique in body contouring procedures beyond the scope of abdominoplasty.