Expanding the Use of Progressive Tension Sutures in Fleur de Lis Abdominoplasty: A New Retrospective Case Series

Abstract

To our knowledge, our institution was the first to describe the novel methodology of combining a drainless tummy tuck technique with the Fleur de Lis (FDL) incision. As accessibility to weight loss medications, such as GLP-1 (glucagon-like peptide-1) increases, so does the resultant population of massive weight loss patients. The enhancement of cosmetic and plastic surgery techniques must continue to evolve to meet patient safety and quality outcomes. Building on our prior work, this series explores the application of progressive tension sutures (PTS) in the FDL abdominoplasty technique; a method that shows promise for patients who have undergone massive weight loss. Previous studies inform us about the efficacy of PTS in drainless abdominoplasties, yet reports of its utility in FDL procedures remain scarce. We present a series of patients who underwent FDL abdominoplasties utilizing PTS. Our approach aimed to remove drain usage while ensuring effective surgical outcomes, including evaluating for post-operative seromas, hematomas, wound breakdowns, and infections. Each patient’s medical history was thoroughly reviewed, Declaration of Helsinki rules were followed and informed consent for participation in the case series was obtained. We successfully implemented the no-drain PTS technique in 16 patients undergoing a FDL abdominoplasty with favorable results. Results included no instances of seroma formation, hematomas, or wound infections, however, 1 patient had a minor incisional breakdown. Patients reported improved comfort levels post-operatively without the requirement for drains. This case series supports the feasibility of performing FDL abdominoplasties with no drains using PTS. Our findings align with earlier research that promotes PTS as a safe alternative to traditional techniques. The evidence suggests an evolving paradigm in abdominoplasty procedures where patient outcomes can be optimized via innovative techniques.