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When Should Breast Augmentation Sutures Be Removed?

asked 3 years ago by imadvice in New York
Latest answer by John P. Di Saia, MD
Question viewed 5,332 times

My crease incision from breast augmentation will be closed with external nylon sutures. I have heard different stories as to the timing of suture removal. Is 3 weeks too long for the nylon suture to be left in place? Will my skin grow over the sutures? What are some of the possible complications with these types of sutures left in place for that long? Your insights will be appreciated. Thanks very much.

18 answers to When Should Breast Augmentation Sutures Be Removed?

Removable sutures and the timing for removal

Hello, Removable sutures need to be removed relatively soon after placement to minimize noticeable scarring, but the exact timing depends upon what other measures have been used to support the wound. If other dissolving sutures are placed under the Nylon sutures, then the Nylon can be removed earlier with little risk of wound disruption. Ask your surgeon as the exact timing depends upon the technique he or she used.

John P. Di Saia, MD
Orange Plastic Surgeon

Suture Removal After Breast Augmentation

The decision in using dissolvable sutures vs non-dissolvable sutures is dependent on the preference of the surgeon. Dissolvable sutures will last longer to maintain the integrity of the wound edges. However, if they are placed superficially at the skin edge, they may dissolve too quickly and lead to the small suture abscess/infection. These little suture abscesses can lead to a noticeable scar. Thus, some surgeons will use non-dissolvable sutures on the superficial skin closure. In... more

T.Y. Steven Ip, MD
Orange County Plastic Surgeon

Suture removal after breast augmentation

Thanks for your question - Each surgeon may use different techniques to close incisions after breast augmentation. In our San Francisco area practice we do not use sutures that need to be removed. When thinking about permanent sutures (like nylon or prolene) sometimes leaving these sutures in for more than a week can leave "track marks" along the incision. This can be avoided when using these types of suture by varying the placement of the suture, for example placing the... more

Steven H. Williams, MD
San Francisco Plastic Surgeon

www.trivalleyplasticsurgery.com

Leaving nylon stitch in for 3 weeks depends on technique.

This is perfectly acceptable depending on the technique used to place the nylon sutures. In many cases the stitch runs beneath the surface and comes through the skin only at the beginning and end of the incision (subcuticular). Leaving it in for 3 weeks tends to keep the wound from spreading wide during the most active part of the healing process. If howeever, individual stitches are placed, then generally, you would want to have them removed prior to 3 weeks to avoid stitch marks. Some... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Check with your surgeon

Hi, Thank you for your question. Three weeks is too long to leave the sutures in place. They should generally be removed within five to ten days. If the sutures are left in too long, this could cause the scar to heal unevenly. Most surgeons use dissovable sutures, but removable sutures are also okay. Usually, the outside sutures are removed within a few days. Make sure that you speak with your board certified plastic surgeon to avoid any possible compllications. Have a great day!... more

Sam Speron, MD
Chicago Plastic Surgeon

Possible additional scarring of breast augmentation incision line

External sutures left in too long will result in a number of small dots located on either side of the incision line. The sutures themselves are a form of trauma that result in small puncture wounds. The body will try to heal the area by having cells travel down the sutures making small scar dots if left in too long. On the trunk, I do not like to leave external sutures in place for longer than 10 days. It would be rare to have additional scarring due to sutures in place for 10 days or... more

Michael Baroody, MD
Danbury Plastic Surgeon

Breast augmentation suture removal

Leaving sutures in place for too long can lead to additional scarring. Factors determining the timing of suture removal depend on the type of skin closure. 1. If there is individual sutures going across the incision, they usually have to be removed within 5-7 days. Otherwise they can cause residual/permanent marks in the skin after they are removed. 2. If you have a removable sub-cuticular closure (in which case you can only see the suture at the ends of your incision), then they can be... more

A. Peter Salas, MD
Manhattan Plastic Surgeon

Sutures and stitch removal after breast surgery

Wounds will epithelialize within 48 hours given an optimal environment for healing and normal perfusion pressures of the skin edges. After breast surgery, a wound will epithelialize within 48 hours, but the underlying tissue needs some time to heal. The underlying tissue takes longer to heal and that is one reason why absorbable sutures are placed in this layer. You should typically wait 5 to 7 days for suture removal.

Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon

I don't use visible sutures that need removal

As you have seen from the answers given most surgeons use dissolvable stitches that do not need removal and are not visible. Speak with your surgeon regarding the use of outside/visible sutures and the reasoning. If they are used, they are typically taken out at about 7days. Make sure your surgeon is board certified in plastic surgery. Good luck.

Bahram Ghaderi, MD
Chicago Plastic Surgeon

Breast augmentation does not require removable sutures.

Hello, again! Most experienced plastic surgeons -- at least in New York -- use dissolvable buried sutures to close breast augmentation incisions. You don't see the suture at all. This gives you better scars, and stitches don't have to be removed.

George J. Beraka, MD
Manhattan Plastic Surgeon

Breast augmenation should not need visible skin sutures

There are several very good approaches to breast augmentation, around the nipple, under the arm, and your choice the breast fold incision. All can be closed with absorbable sutures using a hidden stitch called a subcuticular closure. With this closure none of the suture material comes in contact with the surface of the skin. Generally we then cover the incision line with a glued on paper strip which will resist water and allow immediate showering. Patients do not like to see stitches after... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Each patient is different

There are a variety of techniques to close the incision and while I generally prefer dissolving sutures, sometimes I will also put a few nylon sutures in the top layer which come out in 4 to 14 days. If sutures are left a long time, you run the risk of getting marks from the suture. However, if your surgeon is planning on putting the suture under the skin, it could be removed weeks later without marks. Discuss your questions with your surgeon, who has your best interest at heart. more

Darrick E. Antell, MD
Manhattan Plastic Surgeon

Everyone is different.

I prefer to use burried sutures so that there are not "rail road tracks". If sutures are left in longer than 5 days, rr tracks will form. The longer they are in, the more chance of irritation. sek

Scott E. Kasden, MD
Dallas Plastic Surgeon

Stitch marks

Stitch marks are caused by reaction to stitches going through the skin and skin cells growing down the holes. I usually have no stitches going through the skin and in the event small sutures are needed I will removed them within 3 days, sometimes even the next day. The incisional closure can be reinforced and protected by biological glue or tape for 2-3 weeks. Three weeks is unnecessary for a simple closure under normal skin tension.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Suture removal after breast augmentation

Every surgeon will have their own preference regarding suture choice. Some like to use dissolving sutures with a breast augmentation, as there is no "hassle" during the follow-up visits. If the patient doesn't mind, I prefer to use a suture that I have to take out after surgery, as I think it results in a better scar. (Those stitches that dissolve do so by having the body "react" to the suture, and this can sometimes leave a more pigmented or visible scar.) I take my... more

Michael A. Bogdan, MD
Dallas Plastic Surgeon

Depends on the technique

This will be up to your surgeon, but in my practice I use absorbable sutures as I find they provide an excellent aesthetic result without having any risk of poor scarring. I addition, it's nice for the patients to not have to have sutures removed postop. Talk to you doc, but 3 weeks for nylon sutures sounds a bit long in this case.

Shahram Salemy, MD
Seattle Plastic Surgeon

Depends on the closure

Hello In general , it is best to err on the side of leaving sutures a little longer. Having an incision open up is not in your best interest. If the incision is closed with an underneath stitch that has knots at either end , then pulling it out at 3 weeks is fine. If the incision is closed with individual sutures, the knots may leave significant marks by 3 weeks. We remove sutures anywhere from 6-14 days, depending on swelling, healing of the incision and expected stress on the incision.... more

Francisco Canales, MD
Santa Rosa Plastic Surgeon

Depends on if they are inside or outside stitches

If the Nylons are totally under the skin ("subcuticular") you can leave them as long as you like. If they are on the outside and are left more than 5-7 days they will leave railroad track marks that are permanent and unattractive. I personally gave up on the type of closure that requires suture removal several years ago and use all absorbable sutures without any loss of scar quality. It is nice for the patients not to have to have any suture removal.