Progressive Tension Sutures for Abdominoplasty by Dr. Ronald Schuster, Board Certified Plastic Surgeon

Someone recently sent me an email asking about PTS sutures. They were reading online about these “progressive tension sutures”. This is the thing………

Progressive tension sutures are sutures (stitches) which are used to do two things. The main thing they are used for is to reduce the chance of getting a seroma after surgery. Seromas are unwanted collections of fluid beneath the skin. In general, excess fluid occurs in the body for a number of different reasons. This excess fluid is returned to the circulation through the lymphatic system. After abdominoplasty the lymphatics are temporarily disconnected, making it more difficult fot the fluid to leave the area. It’s important to get rid of the fluid early so that the “skin” can “stick”back down. When the fluid collects it is called a seroma. Small seromas usually resolve by themselves slowly over a few weeks. Some however are larger and won’t go away on their own. If they persist they cause swelling and prevent you from being as flat as you could be. Also there is a risk of having a seroma become infected, which is a whole different problem you want to avoid.

Anyway, these progressive tension sutures are placed to help fix the skin in position. You can think of them as a quilting type of stitch. When properly placed you should not see them at all. I use dissolvable sutures so that they go away after about six weeks anyway. Together with the use of drains, it is the best way to prevent seromas and improve your recovery. I hope this helps to explain the PTS sutures. Let me know what other questions you may have.

Dr. S