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Can Face Lift Fail Because Sutures Are Absorbed to Quickly?

asked 1 year ago by NHaven in Oklahoma City, Oklahoma
Latest answer by Sam Naficy, MD
Question viewed 1,544 times
Tags: neck, absorption, SMAS, sutures

Is it better to use absorbable or non-absorbable sutures? My SMAS failed. Nothing ever tore. Nothing sagged non-symmetrically, just none of the suture anchoring worked. pre and three month post op pictures of neck and jowl are the same. For the first 4 weeks post op when there was swelling, it appeared as if the neck and jaw line were great.

23 answers to Can Face Lift Fail Because Sutures Are Absorbed to Quickly?

Suture technique may be very important for your result

In contrast to some of the other replies to this question, I believe that suturing technique does play a role in your result. It may not be more important that your anatomy, skin characteristics, and genetics, but I do believe that there is a difference depending on the suture used and the technique. I have operated on a large number of patients who had facelifts done in the past. In the large majority of these patients, the skin had been pulled very tight, but the foundation of the... more

Gregory J. Vipond, MD
Pasadena Facial Plastic Surgeon

Facelift Longevity: Technique Dependent

There are many facelift techniques, and not all can deliver long lasting results. The result depends on the patient and the quality of tissue, the technique and on what structure the lift was supported and more importantly how much tension was placed on the structure. It is known that skin only lifts have a high chance of recurrence, as well as just suture suspension of the SMAS. It is likely you did have most of your "lift" placed on the skin and permanent or absorbable, both will... more

Andrew P. Trussler, MD
Dallas Plastic Surgeon

I use permanent sutures for SMAS and muscle tightening in Facelift surgery

I use non absorbable permanent sutures to tighten the SMAS and muscles beneath the skin during Facelift surgery. I know these sutures will hold my correction for many many years. I have found these permanent sutures still intact holding muscle after 18 years when performing a secondary Facelift after the skin overlying the sutured area had aged and sagged again. Theoretically even with non absorbable sutures used in SMAS and muscle tightening, the tissue planes should heal tightly in... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

www.drseckel.com

Fast absorption of sutures after Facelift

Yes, but it's more likely that the SMAS was folded on itself using dissolvable sutures instead of undermining, trimming, lifting and re-suturing the SMAS back together...which is the preferred method of dealing with the SMAS IMHO. I use dissolvable stitches that last several months which is long enough for scar tissue to support the lifted tissues. Inadequate skin removal is another reason that things may appear to have fallen so soon after the Face Lift.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Sutures failing during facelift?

Suture breakage or failure would be an uncommon reason for a facelift to fail. In principle, when we do a facelift, we have to: 1) free up the SMAS and skin appropriately 2) fully release tethering ligaments which prevent the tissues from moving, 3) reposition the SMAS and skin appropriately, (back to where it used to be) 4) hold them in the right positions until it all heals. 5) hope that the tissue quality is sufficient to maintain this... more

Thomas Fiala, MD
Altamonte Springs Plastic Surgeon

Reason for unsuccessful facelift

Although proper suture placement is important, sutures alone are likely not the only reason for your result. These are some of the questions that come to my mind: 1) was a proper surgical plan developed to adequate treat your signs of aging, 2) was proper underming performed; 3) was the SMAS treated correctly; and 4) was facial volume/hollowing addressed properly. Please talk with your plastic surgeon to have your concerns addressed.

C. Bob Basu, MD
Houston Plastic Surgeon

Facelift sutures are not the problem

I personally don't feel that the type of suture is all that important. Once the deeper tissue is lifted, it only has to stay there a few weeks before the healing process will keep it there forever. More than likely, a technique of facelifting was performed that was inadequate for your particular anatomy. I would recommend discussing your concerns with your surgeon. If a better technique is available, consider a revision facelift. If there is only one technique that surgeon... more

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon

www.campbellplastics.com

Preventing sag: Absorbable or permanent sutures (stitches) for face lift: Crude analogy offered to explain

The use of sutures and techniques to achieve correction of facial sagging are very important. However, if the long term results depend on the suture than the wrong technique was used. Generally speaking sutures hold things in place until the healing of the tissues can take over the work of the sutures which need to remain present for as long as it takes to heal for the critical portions of the procedure. Thereafter the permanency of the sutures should be irrelevant. If this sounds too... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Why Facelifts Fail- 3 main Reasons

Facelifts fail to work for 3 main reasons 1. The Facial aging process was not addressed with the technique used. For example, if you do skin only facelift for advanced facial aging..........it will fail long term . 2. Not enough Deep layer lifting or manipulation was done on the SMAS. If you want longevity in a facelift, you need to alter the deep layers . 3. Did not address the true cause of the aging process. This is very common in which only a FACIAL more

Rod J. Rohrich, MD
Dallas Plastic Surgeon

Facelift Sutures

If you do not see a change at 3 months, this problem has nothing to do with the type of sutures, but everything to do with the surgical technique utilized. A properly executed facelift should deliver long lasting results. Issues to take into consideration. 1. Did a suture loosen or pop? Unlikely if both sides are loose 2. Do you smoke? Smoking can significantly shorten the longevity of a great facelift 3. Do you have excessive sun... more

Paul S. Gill, MD
Houston Plastic Surgeon

SMAS ISSUE

The SMAS prodedure - if one was done - did not have longevity. As said previously, visit your surgeon and discuss your concerns - hopefully, you both are on the same page.

Wayne R. Perron, MD
Calgary Plastic Surgeon

The results more depend on the surgical planning than the sutures

I use absorbable sutures and never had such a issue. i have had few cases that results were not up to my expectation and required redo . Please talk to your surgeon and do start with blaming your surgeon. i would suggest that you discuss your expectations and you may need to have revision. Your surgeon should charge for the revision and you should pay for the anesthesia and surgery center fees.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Deep sutures for face lift

Although I use permanent sutures, I feel that long-lasting absorbable sutures also provide a lasting support as the scar tissue is eventually what holds the lift up

Sam Naficy, MD
Seattle Facial Plastic Surgeon

Do Absorbable Sutures Work for Facelift Surgery

Yes, absorbable sutures absolutely work! Personally, I only use absorbable sutures. By the time they melt away (about 3 months or so), the facial tissues have found their new place and don't rely on stitches holding everything up. Inappropriate would be fast-absorbing sutures (such as gut sutures) but do not think your surgeon would use this suture material for a facelift. Therefore, I doubt your disappointment is a result of sutures failure. If your before and after photos... more

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon

www.drfechner.com

Facelift failures usually have little to do with suture type

Failures of facelifts typically have nothing to do with the types of sutures used but rather the technique of the facelift AND the preoperative characteristics of the patient's skin and anatomy. It is very common practice to use absorbable sutures while performing a facelift -- some surgeons use a combination of absorbable and non-absorbable sutures. I use a combination of absorbable (which dissolve in approximately 5-6 months) and nonaborbable sutures. It is... more

Vishal Banthia, MD
San Jose Facial Plastic Surgeon

Facelift results

Wihtou knowing what exactly was done in the operating room and seeing the pre andp ost-op results, it is difficult to give any reasonable answer to your question. If you are unhappy speak with your surgeon.

Steven Wallach, MD
Manhattan Plastic Surgeon

Suture Absorption Rate May or May Not Affect Your Face Lift Sag

There are several different techniques regarding facelift, and I feel the most important is the strategy used on your particular face. The type of suture, in my opinion, is usually secondary. With a more limited facelift, it's common to use an absorbable suture that is actually anchored to bone. With other techniques, the SMAS is tightened using permanent or absorbable suture, anchored to SMAS or bone or both. The amount of tightening or pulling done... more

Roy Kim, MD
San Francisco Plastic Surgeon

Facelift and Variety of Sutures Used: Yes and No

This is a very good question, and my answer has two parts. I do believe that the duration of result in the neck has some relationship to the type of suture used. Because the platysma is a dynamic muscle, my impression is that recurrence of platysmal bands (the cords that form in the neck as one ages) is more likely to occur with absorbable than with permanent sutures. For this reason, I use a Mersilene suture for the playsmaplasty, which is a form of braided Nylon... more

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon

www.drprendiville.com

Early loss of "lift" after facelift

I am sorry to hear that the results were so short-lived. The longevity of your lift is likely related to the technique of the lift rather than the sutures. I would echo my colleagues advice to return to your surgeon and voice your concerns. Cosmetic surgeons truly want their patients to be happy. While we'd rather not have to experience less than optimal results it behooves all of us to do our best to give patients great results even in cases where a revision or touch up is required... more

Stephen Weber, MD
Lone Tree Facial Plastic Surgeon

www.lonetreefacial.com

Sutures in facelifts

There are many different types of sutures that may be used in facelifts, both permanent (non-absorbable) and absorbable, which the body gradually breaks down over variable amounts of time. If you feel like the results of your procedure have faded or disappeared only a few months after your surgery, you should discuss your concerns with your surgeon and see if a revision may be indicated.

Olivia Hutchinson, MD
New York Plastic Surgeon

Sutures and a SMAS Facelift

I use sutures that slowly dissolve over an extended period of time (prolene, mersiline). I believe sutures are not the reason for failure of a facelift. The technique used to advance the SMAS and to remove redundant skin must be executed expertly. Dr. ES

Earl Stephenson Jr., MD, DDS
Atlanta Plastic Surgeon

Not all faces do best with a smas lift - some pictures would help

Depending on the reasons for your jowls and neck sag, you might have needed additional or different maneuvers to get a better result. Dr. Mayl Fort Lauderdale

Nathan Mayl, MD
Fort Lauderdale Plastic Surgeon

Failed facelift

I personally use absorbable sutures for the SMAS and can't recall something like this happening. The fact that things looked good for a while speaks well of the work your surgeon did. The best thing is to sit down and discuss this with him/her and make a plan. You might need to redo it but you also need to know that the elasticity of your own tissues may prevent you from getting the result you hoped for.