![[ Visit Client Website ]](images/banner.gif)
Background: Scar retraction and soft tissue depression compromise aesthetics
and cause social embarrassment. 1,2,3,4 The purpose of this study was to evaluate the
results of treating soft tissue depressions or retractions at varied anatomy regions with
combined upward suture traction and percutaneous subcision.
Methods: There were 40 patients (age: mean, 39 y; range, 22-55 y; 39 women and 1
man) (total, 77 soft-tissue lesions), who had treatment with the present technique from
1996 to 2014. Postoperative follow-up was from 6 months to 2 years. The treated
anatomic areas were evaluated in 5 groups: (1) face (8 patients;8 lesions);(2) gluteal
(16 patients; 45 lesions); (3) breast (7 patients; 10 lesions); (4) abdomen (7 patients; 7
lesions); and (5) lower limb (2 patients; 6 lesions). The technique consisted of placing a
2-0 nylon monofilament suture deep at the core of the depression. The stitche is pull up vertically using a needle-holder. The adhesions is released using a pink needle, or miniblade BD 16 or 18G Nokor needle placed percutaneously through a small incision and working in a circular movement.
Results: The depressions were released successfully in all patients. Bruises around
treated areas persisted for 2 to 3 weeks. Moderate induration persisted until three
months. In the gluteal region, 6 patients who had retracted areas with diameter > 5 cm
developed seroma after treatment that resolved after needle aspiration or
placement of a Penrose drain for 2 weeks (2 patients). Cases of cellulite grade 3 presented satisfactory improvement after two or three ambulatory sessions (Fig. 1).
Conclusions: The present results confirmed the efficacy of the combined subcision
method with upward traction at diverse body sites as previously reported by the authors for inverted nipple in the breast grade II and III.5
Fig. 1 -Preoperative view of a 45-year-old woman who had severe retraction at the chin after resection of granuloma as an iatrogenic complication of methacrylate cement; Postoperative view 20 months later after second stage of combined upward suture traction and percutaneous subcision of adhesions refined with minimal subdermal lipoplasty.