Aesthetic SurgeryThe Peruvian Fisherman's Knot: A New, Simple, and Versatile Self-Locking Sliding KnotRamirez, Oscar M. MD, FACS*; Tezel, Erdem MD†; Ersoy, Burak MD†Author Information From the *Department of Plastic and Reconstructive Surgery, John Hopkins University, School of Medicine, Baltimore, MD; and †Department of Plastic and Reconstructive Surgery, Marmara University, Istanbul, Turkey. Received December 29, 2007 and accepted for publication April 28, 2008. Reprints: Erdem Tezel, MD, Tophanelioglu Caddesi, Marmara Universitesi Tıp Fakultesi Hastanesi, 13/15, Plastik Rekonstruktif Cerrahi Departmanı, Altunizade/Uskudar, Istanbul, Turkey. E-mail: firstname.lastname@example.org. Annals of Plastic Surgery: February 2009 - Volume 62 - Issue 2 - p 114-117 doi: 10.1097/SAP.0b013e31817e2c9e Buy Metrics Abstract Background: In many plastic surgery operations that are undertaken through relatively small incisions resulting in deep-seated operating fields, sliding knots with a self-locking property are preferred by plastic surgeons for 3 reasons: simplicity, reliability, and versatility. We describe a new and versatile sliding knot that can be easily sledded and locked. Methods: The technique of knot tying is described in detail as a stepwise approach with photographs. The main advantages of the Peruvian fisherman's knot are compared with other methods and summarized. Results: In addition to its adjustment-related properties, knot security has been adequate with this knot as evidenced by its clinical performance and the authors’ experiences to date. Conclusion: The Peruvian fisherman's knot is especially useful while working in deep seated operating fields through a small incision. Tension created during knot tying is adjustable, which makes it an ideal choice for various lifting procedures in plastic surgery. © 2009 Lippincott Williams & Wilkins, Inc.