New Tummy Tuck Technique

New tummy tuck technique for wound closure

As a cosmetic plastic surgeon I am constantly trying to improve my surgical results and, in particular, the quality of the scars cosmetic surgery leaves. A smaller, thinner scar that is less visible is an important goal for any plastic surgeon. Also, if a surgical technique can improve the outcome and be faster it is preferable. After all, the less time you are under anesthesia, the better it is for you and the less your cost will be! See here for a related post: https://tavmd.com/2010/12/14/abdominoplasty-without-drains/

Finally, if the new innovation can make the patient’s and plastic surgeon’s care of a wound easier, so much the better. A new technique in wound closure for long incisions such as tummy tucks and breast surgery may be able to do all of the above.

Here are some photos of abdominoplasty: https://www.tavmd.com/tummy_tuck_abdominoplasty_photos_va.html

New tummy tuck wound closure with glue

For a number of years, plastic surgeons have had glues like Dermabond at their disposal for closing wounds without tension. Unfortunately, most wounds in cosmetic surgery involve removal of some skin and by necessity have tension—as such, they are not ideal for wound closure with glues. The glues have worked very well for closure of small incisions in places such as the cheek or face.

Abdominoplasty closure with Glue

 

Prineo wound closure photo

New technique for wound closure with glue

The new innovation that may be the answer to wound closure that has some tension is the Prineo dermabond system developed by Ethicon. The idea is to approximate the deeper tissues, apply tape to the wound and then place glue on top of the tape. This provides for a stronger closure over a longer distance. The glue once polymerized by contact with the tape provides a strong physical barrier to bacteria and improves sterility. The patient can shower immediately and the dressing is left in place until it naturally falls away after a few weeks.

 

 

 

I have tried the new technique on four patients so far—here are my results!

  • The wound remained closed at the post-operative visit
  • The surgery took less time
  • The post-operative visit was less uncomfortable for the patient
  • The post-operative visit was shorter
  • The patient had an easier post-operative care regimen—no need for changing dressings or applying antibiotic ointment twice a day.

 

Here is the usual care regimen after an abdominoplasty:

https://tavmd.com/2011/03/13/care-after-a-tummy-tuck-abdominoplasty-part-1/

https://tavmd.com/2011/03/17/care-after-a-tummy-tuck-abdominoplasty-part-2/

I will report later on how good the cosmetic result is once a month or so has passed. Meanwhile, I am rather impressed by the advantages of the Prineo dermabond system for wound closure of abdominoplasty incisions. Let’s wait and see.

Here is more information on abdominoplasty: https://www.tavmd.com/surgery-info/tummy-tuck/

P.S. Here is a similar technique being used by dermatologists for closure of cheek wounds; looks like it’s catching on.

http://cosmeticsurgerytimes.modernmedicine.com/cosmeticsurgerytimes/article/articleDetail.jsp?id=726604&sk=95be0863b665d3fcb0557cebf2c9db37

 

Morad Tavallali, M.D., FACS