Functional and Aesthetic Impact of Progressive Tension Sutures in Abdominoplasty

Background: Progressive tension sutures (PTS) have emerged as a key technique in abdominoplasty, initially to reduce complications such as seroma formation, and more recently to enhance aesthetic outcomes. This study evaluates the clinical and aesthetic impact of PTS in lipoabdominoplasty. Methods: A retrospective analysis was conducted on 291 patients who underwent lipoabdominoplasty with standardised PTS placement between October 2021 and October 2024. The surgical protocol included 360 circumferential liposuction, limited central undermining and PTS application for anatomical contouring. Patient satisfaction was measured using a validated five-point Likert scale. Descriptive statistics summarised outcomes. Results: The mean patient age was 38.1 ± 9 years; 90.6% were female. The overall complication rate was low: seroma occurred in 7.8% (back) and 3.1% (abdomen), with minimal rates of widened scar (3.1%), hypertrophic scar (3.1%), wound dehiscence (1.6%) and necrosis (0.8%). No secondary procedures or scar revisions were required. Patient satisfaction was high: for abdominal shape and contour, 95.9% were satisfied or highly satisfied; for umbilicus shape, 94.9%; for scar quality, 93.5%; and for skin laxity, 97.9%. Conclusion: The addition of PTS to lipoabdominoplasty increases operative time by only 15–20 min but significantly reduces seroma formation and improves both aesthetic outcomes and patient satisfaction. PTS should be considered a standard component of abdominoplasty. Further multicentre studies are recommended to standardise technique and optimise outcomes.