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Stitches Did Not Dissolve After Breast Reduction?

I had a Breast reduction May 19, 2009 and my doctor told me that he used dissolvable stitches. I assumed that by now being almost 8 weeks out that the clear stitches he used would have already dissolved.

I have several that are visible outside of the skin and one spot that is really red. It almost looks like how a pimple looks but it’s irritated and hurts because its embedded weirdly in my skin.

Today, I went to see my doctor and he removed the painful stitch and it felt much better. Now I noticed the pain is back again and I can feel another stitch in the same spot he removed it from earlier. It is kind of buried in the skin and in order to remove it you have to stick tweezers into the pimple looking wound. What do I do to make them dissolve?

Doctor Answers (9)

Stitch abscesses

+3

The dissolving sutures which we use to close wounds are usually well tolerated, however patients don't come with a "user's manual", advising physicians which sutures to employ. Many physicians prefer to repair breast reduction scars in layers, using clear, colorless sutures, (Monocryl, PDS, etc) which disintegrate slowly, up to 6 months post-op. Occasionally however individual suture knot remnants tent the skin, breaks it and causes a pink, "pimple" like response. This can be corrected, as your physician did, by removing the knot.

More recently, some plastic surgeons have been using an absorbable "barbed" suture, which can also produce this effect with several "pimples" occuring like pearls on a string. This isn't as readily corrected, because it usually means that the barbs are too superficial and thus more likely to "spit". Hope this helps.


Orange County Plastic Surgeon
5.0 out of 5 stars 37 reviews

Sutures for Breast Reduction Surgery Typically Last 6-9 Months

+1

It’s not unusual to use long lasting absorbable sutures when performing breast reduction surgery.  These sutures typically last six to nine months, and are buried beneath the skin.  They are used in an effort to avoid spread of the scar.  They provide support to the wound closure, until the wound has gained adequate strength.
Occasionally these sutures work their way through the skin before they can absorb.  When this happens, it’s not unusual to develop an infection around the stitch.  This can result in a stitch abscess or granuloma.  This is the pimple you describe.
This situation usually requires drainage of the abscess, removal of the suture remnant and possibly antibiotics.  This is a relatively simple problem to deal with if treated early.  If diagnosis and treatment are delayed, then more significant problems can result.
It’s not unusual to have absorbable sutures protrude through the skin following breast reduction surgery. With appropriate care this should represent a minor problem with no long term consequences.  If you have protruding absorbable sutures, follow-up with your plastic surgeon is indicated.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 75 reviews

Stitches Did Not Dissolve After Breast Reduction

+1

Although I am a fan of dissolving sutures sometimes the knots are too close to the skin and they spit out and cause an abscess.  This is usually because the enzyme level close to the surface is not as strong to disintegrate the material used for suturing.  I use Vicryl sutures for most of my closures and very rarely get a suture abscess due to burying the knots deep below the dermis in the subcutaneous fatty layer.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
5.0 out of 5 stars 38 reviews

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Breast Reduction and Stitch Problem

+1

Thank you for the question.

Some of the sutures used during breast reduction surgery are longer-lasting;  it sounds like some of these have come to the surface in your case. Once these sutures are  removed  your incision line should go on to heal nicely.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 715 reviews

Stitches remain after breast reduction

+1

Breast reduction surgery is a very popular and effective way to remove tissue that may cause symptoms such as pain or discomfort and to contour the shape and position of your breasts. In our practice, we emphasized that there is a significant recovery process after breast reduction surgery. During the surgery, we only use sutures that will dissolve on their own. This process may take anywhere from 6 to 9 months depending on the type of suture that was used. If you continue to have the suture after that time was a suture has broken through the skin, you should return to your plastic surgeon will assess you and determine if the suture can be safely removed.
 

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 65 reviews

Suture abscess or exposure

+1

Dissolvable sutures are great and I used them all the time. However, once in a while before the completely dissolve, they can make their way out of the skin and cause the problem that you just mentioned.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Breast reduction stitches sometimes come to the surface.

+1

hi.

This is not a big deal.  We use a lot of buried stitches during breast reduction surgery, and some don't stay buried.  As soon as you see one coming out, get it removed, so the scar is not affected.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Failure of Sutures to Dissolve Following Breast Reduction

+1

Slowly dissolving suture materials are a mixed blessing. They often require at least 90 days to dissolve and often longer. While it is somewhat frustrating when these sutures fail to dissolve, their use also often leads to a better ultimate scar. You might try massaging the scars with vitamin E or ScarFade. Sometimes this accelerates the process. Also, do not hesitate to keep returning to your surgeon to assist in removing problem areas, especially knotted ends of the suture.

John Whitt, MD
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

These are probably PDS, Maxon or Monocryl

+1

Hello,

Long term dissolvable sutures have good points and bad points. They help control the width of scars making them stay thinner by taking some time to dissolve. This can be six months. The bad part is that some patient's bodies react to them like your seems to be and form little pus pockets sometimes.

Not all of your sutures will do this, but you might have a few problems over the next few months and your surgeon may want to take note of the suture type to which you seem to be having the problem to avoid it if there is a "next time."

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 23 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.