Scarring Concern from Open Rhinoplasty with Dissolvable Stitches

I'm concerned about scarring from open Revision Rhinoplasty with dissolvable stitches over columella. How long until they fall out? Do dissolvable stiches in this area mean more or less scarring? Any downsides?

Doctor Answers (9)

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Revision Rhinoplasty: Suture Choice Less Important than Surgeon's Skill

+3

The type of suture (stitches) used to close the columellar incision (incision between the nostrils) in open rhinoplasty has less of an impact on the visibility of the scar than the surgeon's skill and attention to detail.

While dissolvable sutures such as "chromic" and "fast-absorbing-gut" have been shown in studies to produce slightly more tissue inflammation than permanent sutures such as "nylon" or "prolene", excellent wound closure can be attained with dissolvable sutures.

Dissolvable sutures should remain in place for a minimum of 5-7 days to ensure that the incision has healed shut adequately. Most of these will dissolve sometime in the 7-14 day time period. Follow your doctor's recommendations on wound care to ensure that you get the best possible result.


Dallas Facial Plastic Surgeon
5.0 out of 5 stars 85 reviews

Scarring after Rhinoplasty skin incisions

+2

Your columellar skin incision will typically heal well, regardless of the type of suture. We frequently use absorbable sutures in the facial skin.

These stitches always fallout. If they are irritating you, ask your surgeon to remove them.  

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Open Rhinoplasty Incisions

+2

Incisions in the columella of the nose tend to heal well regardless of the type of suture used. If the skin edges are well aligned and allowed to heal for an appropriate time the results are usually excellent. If the dissolvable sutures have not fallen out by two weeks the surgeon will usually remove them.

Ira D. Papel, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Open Rhinoplasty incisions heal well in just about everyone.

+2

Revision rhinoplasty is one of the most difficult, humbling operations I perform. I couldn't imagine getting a favorable, predictable result without the small columella incision.

I typically use 3 permanent sutures, and 2 absorbable sutures to close the columella. This is done purely out of habit, since that's the way my mentor trained me 11 years ago. I think this incision has a high likelihood of healing well no matter what stitches are placed. All of these sutures are removed 7 days after surgery.

You should be confident that your surgeon is board-certified, and an experienced rhinoplasty surgeon. You should also see many favorable photos before proceeding.

I hope this helps, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 268 reviews

Open rhinoplasty scarring and scars

+1

I have a very specific protocol for my open rhinoplasty surgeries, in which I use prolene sutures for the skin and absorbable for the mucosa.  This yields excellent scars. 

 

Open rhinoplasty.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 46 reviews

Generally dissolvable sutures work well

+1

Generally dissolvable sutures work well, and dissolve within 7-10 days.  Any incision on the nose will take about a year to mature.  You can also consider fractional laser on the scars to reduce any scarring even further.  Follow up with your physician to ensure he/she is happy with the outcome.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.