title: Treatment of Skin Depression with Combined Upward Suture Traction and Percutaneous Subcision.
abstract: Scar retraction and soft-tissue depression may compromise aesthetics and cause social embarrassment. 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 years; range, 22-55 years; 39 women and 1 man) (total, 77 soft-tissue lesions) who had treatment with the present technique from 1996 to 2013. 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; 46 lesions); (3) breast (7 patients; 10 lesions); (4) abdomen (7 patients; 7 lesions); and (5) lower limb (2 patients; 6 lesions). The technique included placing a 2-0 nylon monofilament suture deep at the core of the depression, pulling vertically up with the suture, and using a needle or miniblade (placed percutaneously or through a small incision) to release the adhesions.
  
  
  RESULTS
  The depressions were released successfully in all patients. Bruises around treated areas persisted for 2-3 weeks. Moderate induration persisted until 3 months. In the gluteal region, 6 patients who had retracted areas with diameter >5 cm developed seroma after treatment; the seromas resolved after needle aspiration or placement of a Penrose drain for 2 weeks (2 patients).
  
  
  CONCLUSIONS
  The present results confirmed the efficacy of the combined subcision method with upward traction at diverse body sites as previously reported for inverted nipple in the breast.
authors.affiliation: Plastic Surgery Department, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil; Universidade Federal de Santa Catarina; Universidade do Vale do Itajaí; and Universidade Federal de Santa Catarina -Clinica Jane- ILHA Hospital.
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Pereira
authors.affiliation: Plastic Surgery Department, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil; Universidade Federal de Santa Catarina; Universidade do Vale do Itajaí; and Universidade Federal de Santa Catarina -Clinica Jane- ILHA Hospital.
authors.forename: Jorge
authors.initials: J
authors.lastname: Bins-Ely
authors.affiliation: Plastic Surgery Department, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil; Universidade Federal de Santa Catarina; Universidade do Vale do Itajaí; and Universidade Federal de Santa Catarina -Clinica Jane- ILHA Hospital.
authors.forename: Elizabeth Machado
authors.initials: EM
authors.lastname: Paulo
authors.affiliation: Plastic Surgery Department, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil; Universidade Federal de Santa Catarina; Universidade do Vale do Itajaí; and Universidade Federal de Santa Catarina -Clinica Jane- ILHA Hospital.
authors.forename: Kuang Hee
authors.initials: KH
authors.lastname: Lee