Karol A. Gutowski, MD, demonstrates an abdominoplasty with a no drain technique, which uses internal progressive tension sutures to bring the abdominal skin flaps back down to the abdominal wall to close off the dead space. Barbed, mono-directional sutures are used in this technique to make the process faster.
Dr. Gutowski begins by describing the preopertive markings for the case and then proceeds to the liposuction, utilizing indirect undermining using a power assisted liposuction cannula to allow for more liposuction and more lipoaspirate without compromising the skin flap.
Next, the abdominal flap is raised to the level of the umbilicus, and Dr. Gutowski focuses on creating a central tunnel for the rectus fascial plication. The redundant skin is then excised, followed by the placement of the progressive tension sutures with two rows on each side.
Finally, closure is performed with barbed sutures, and the umbilicus is brought out at its normal location.