I'm going to get two acne scars excised on a Wednesday, but I fear they may be left in too long if I have to wait until at least Monday to get them out. Also, what can I ask the plastic surgeon to do to mitigate the scar as much as possible? Thank you.
What is the Absolute Longest Stitches Should Stay in the Face?
Doctor Answers 11
Ideal timing of suture removal on the face
Typically, sutures in the face would be ideally removed 5-7 days after placement, but the final decision about when to remove them would depend on careful examination of the wound for signs of adequate healing before removal.
It is not unusual or inappropriate to remove them a day or two later if the surgeon's judgment indicates this would be in your best interests, so if scheduling limitations require this you should not assume it will be harmful to your outcome.
Stitches in the face
I like to remove facial stitches 5 days after they are placed. I think your plastic surgeon has you right on target as far as the interval for stitch removal. Occasionally stitches can be removed sooner than 5 days if the area appears to be really well healed, but if they are removed too soon, you risk having the wound edges pull apart. After the stitches are removed, the area can be left to heal on its own or resurfaced either with manual dermabrasion, CO2 or erbium:YAG laser. Sun protection/avoidance of the healing scars is important.
Acne scar surgical removal. stitches can stay in for a week or slightly more
Depending on how an acne scar is excised, if there are deep dissolving stitches, the superficial non-dissolving stitches can be removed between 5-7 days on average. There are exceptions for shorter and longer term stitches but not by many days.
I close wounds with multiple layers of stitches so the deeper dissolving stitches take all the tension off the surface of the skin and the top layer of stitches (that get removed in a week) create no tension on the skin surface so they don't create the railroad track marks. I also can use a very fine diameter suture on the surface as there is no tension in this layer and the stitches don't leave marks.
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Sutures in the face
As previously noted, the face has an excellent blood supply which allows for very favorable scars (assuming a tension free closure and meticulous technique). I would maintain that stitches should stay in at least 5 days and no longer than 8 (wound separation can potentially occur if sutures are removed too soon). The type of skin suture used in my practice is a 5-0 or 6-0 prolene, which is a non-reactive mono filament suture.
Time Span Is Fine
The face has an excellent blood supply so a five day span is fine. In fact, for facial sutures, 4-7 days is the norm. I would be pretty certain that the plastic surgeon would do all he/she can to mitigate the ensuing scar. This would include undermining, placing the suture in the proper direction, and using a deep, buried subcutaneous suture. A dressing with a breathing membrane over the scar site will help as will the use of a silicone gel product such as ScarGuard-MD.
When to remove sutures
In most cases, I remove sutures from the face in 4 to 7 days. After this time, the suture holes start to scar and may leave permanent changes. In some cases, you can have internal dissolvable sutures inside and surgical glue (Dermabond) outside, so there is no evidence of sutures externally. Good luck.
Facial Stitches should BEST be removed within 5 days
For IDEAL healing
- the incision needs to be placed within the facial wrinkle lines so the scar ends up with little to now pull on it
- the margins of the wound need to be undermined so the wound is closed with little to no tension
- dissolving stitches need to be put with the knot placed deeply (IE buried) to place any tension in the deep layer and not in the skin itself
- fine (5-0 or 6-5) non reactive stitches (Nylon or Prolene) are placed in the skin with the needle penetrating the skin vertically
- Stitches need to be removed within 5 days to avoid in growth of skin into the stitch tunnels resulting in "railroading"
- You should keep a 45 SPF and higher sun block on the wounds for the next 6 months to prevent scar darkening
Dr. P. Aldea
Stitch removal in the face
ASs lond as the stitches aren't tied too tight and are removed in 5 days, you shouldn't have railroad track from the stitches. Wednesday to Monday should be fine.
Stitch marks can be minimized by using small or buried sutures or adhesive or glue rather than sutures. If sutures are placed through the skin, depending on the amount of tension they should be removed within 3 days or so due to ingrowth of skin cells into the suture tunnels. Often i will place sutures for just 24 hours to allow the body's nature "glue" to keep the skin ends together then replac ethe stitches with steristrips.
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