Drainless Lipoabdominoplasty Using Progressive Tension Sutures, Scarpa's Fascia Preservation, and Minimal Cautery in
Background:
Lipoabdominoplasty has soared in popularity. Advancements in the procedure have led to improved abdominal contours. Despite improvements in surgical techniques, postoperative complications persist, especially seroma formation. Drains are commonly used to reduce the risk of seroma formation; however, drains are a nuisance for patients and may contribute to long-term complications. Many surgical strategies have been proposed to reduce seroma formation in lipoabdominoplasty, including progressive tension sutures (PTS), minimal cautery, and preservation of Scarpa's fascia; however, these strategies in combination remain underexplored.
Objectives:
The objective of this study was to determine the postoperative seroma rate of lipoabdominoplasty with combined PTS, minimal cautery, and Scarpa's fascia preservation without postoperative drains.
Methods:
This is a review of 350 patients who underwent drainless lipoabdominoplasty performed by a single surgeon from January 2017 to December 2024 at a single surgery center. Patient demographics, operative characteristics, and postoperative outcomes were collected. Descriptive analysis was performed. Pearson's χ2 and Mann-Whitney U tests were used to compare groups. Multiple logistic regression analysis was performed. Statistical significance was set at P < .05.
Results:
Among 350 cases, a total of 286 full abdominoplasties, 50 belt lipectomies, and 14 modified float abdominoplasties were performed. There was a total of 32 (9.1%) complications, with a 2% seroma rate. There were no mortalities. All patients who developed complications recovered without sequelae.
Conclusions:
The drainless lipoabdominoplasty can be performed safely with a low seroma rate using a multimodality approach that includes progressive tension sutures, minimal cautery, and preservation of Scarpa's fascia.
