Skin Wont Heal over Permanent Sutures? (photo)

I had a Rhinoplasty 4 months ago & everything healed except for 1 spot. You can visibly see some of the permanent sutures (they are dark green) in the skin. It seems to be 1 very small hole that won't heal over this spot. I have been back to the surgeon a few times & was put on antibiotics & used Bactroban oint for 3 weeks. Nothing is working & her next "best solution" is to cut the sutures out, however that may cause the septum to shift back.. How can I get this skin to close over the sutures?

Doctor Answers (11)

Permanent suture can be removed at this time

+1

Hello,

Thank you for the question.  Your body has decided that it cannot heal on top of the permanent suture and wants it out.  The good news is that at 4 months most of the strength of the healing has occurred.  You and your plastic surgeon have given your body an ample amount of time to heal so it makes sense to take the suture out at this time.

All the best,

Dr. Remus Repta


Scottsdale Plastic Surgeon
5.0 out of 5 stars 95 reviews

Skin Wont Heal over Permanent Sutures?

+1

Dear QuestionSeeker,

Thank you for your question and photo.  I do not use permanent sutures in any of my rhinoplastys because it is not necessary. Once the cartilage heals in the proper position, it no longer needs sutures to support it.  You should be at this stage now.  I would ask your surgeon to remove the suture as not only will it not heal, but it can continue to errode and cause a septal infection and eat away at the cartilage.  Visit your surgeon to get it removed.

Best Wishes,

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 28 reviews

Retained suture(s) 4 months post Rhinoplasty.

+1

Thanks for the photo; it clearly shows at least one retained suture (it doesn't look green to me, but that's immaterial).  At 4 months it is obviously not a dissolving suture, and it obviously hasn't responded to conservative measures.

By now, however, your septum position is firmly encased and immobilized by scar, and the suture(s) can be removed with impunity. Scars do take a full 6-12 months to mature, and cartilage has innate "springiness" or memory that tends to make it want to return to its previous deviated position . . .

 . . . BUT, in this position your caudal septum is unlikely to shift out of position with suture removal, which is necessary for healing to take place. A contaminated suture will not be "sterilized" by topical or oral antibiotics, and the foreign body must be removed, after which rapid healing should occur. If it doesn't, you may have infection in the cartilage, which is another reason suture removal should be done promptly.

See your surgeon and get the suture material out now. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 126 reviews

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Suture in nose after rhinoplasty

+1
  • As the other surgeons have stated, this is a suture is best removed to allow the incision to heal. 
  • It may be a absorbable green suture (there are many types), but contact your surgeon for a visit
  • Best Wishes

Travis T. Tollefson, MD, MPH
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Skin Wont Heal over Permanent Sutures? (photo)

+1

Return to your surgeon ASAP for removal of these permanent sutures. This should only be done by a surgeon in fact! 

Darryl J. Blinski, MD
Miami Plastic Surgeon
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Why skin will not heal over an exposed stitch...

+1

Whenever there is an exposed stitch, such as yours, the only way the wound will heal is by removing it. By now, the internal scarring should maintain your result, but not removing the stitch could lead to problems.

My advice? Get the stitch taken out!

Good luck

Marc Pacifico, MD, FRCS(Plast)
London Plastic Surgeon
5.0 out of 5 stars 12 reviews

Exposed permanent suture

+1

It is highly unlikely that the one exposed permanent suture is holding the septum in its new location so removal should have no effect on the final outcome.  Not removing the suture may result in an infection of the septum so please have the suture removed.

Joseph N. Togba, MD
Oakland Plastic Surgeon
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Skin Wont Heal over Permanent Sutures?

+1

      The tissue in this area heals quickly normally, and it will likely not heal with the foreign body in place given that 4 months has elapsed.

 

 

 

Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 218 reviews

Exposed suture

+1

The suture is obviously exposed. I would recommend just having your surgeon remove it, which should not really be a big deal. There is probably enough scar tissue now that it shouldn't make a difference. 

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 27 reviews

Stubborn Spot

+1

I agree that in most cases, the suture has to be removed in order for the stubborn spot to heal.  Since you are 4 months post-op, I would expect that you would have formed sufficient scar tissue to help keep the septum in the midline.  In my experience, even if you were able to magically make the skin heal over the spot now, in the future, you would likely end up with recurrence of the same problem.  Best to take it out.

Dara Liotta, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 11 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.