I attended the American Society of Plastic Surgeons meeting in San Diego recently. With pandemic restrictions and other commitments, I had not been to an in person meeting in awhile. There are plenty of learning opportunities on line, but there is no substitute for being there. Perhaps the best part is the vendors hall. It is sprawling and there are row upon row of things to buy. It’s like a surgeon’s toy store. Between the lectures and the vendors, I have many new thoughts and projects to keep me busy as well as subjects for my blog.
One topic to discuss is drains in abdominoplasty. About 90% of plastic surgeons use drains in their abdominoplasties. The main benefit is to limit seroma (fluid pocket) formation, but proponents say this is not the case. So I took a course to learn more. The lecturers presented some nice result and had impressive statistics for minimal seroma formation. Upon further discussion, however, there are always trade offs. To my observation, the release and removal of tissue appeared to be relatively limited and the presenters admitted with heavier patients with more extensive liposuction, they did place drains. Also without drains in place, the tissues were edematous (swollen).
What did I learn then? The lecturers used an internal quilting technique with barbed sutures that adds time, but helps stabilize the tissue flap. I have used this approach a few times already and found it to be useful to remove drains earlier while still performing a wide tissue mobilization and also minimize edema. Techniques are always in evolution and the next time I see a better idea or experience dictates, I will continue to update. Visit my abdominoplasty gallery to see some cases.
