Am I Having an Allergic Reaction to Long Term PDS and Permanent Sutures Used on my Face Lift Performed 10 Months Ago?

Question

I have had ongoing issues along the areas where sutures were placed for my deep plane facelift. In addition to continued but lessoning swelling and numbness, I have had periods of inflammation, redness, itching and rash-like little bumps behind my ears and along that part of my hairline extending down the sides of my neck. I also feel several little gnarly bumps under the skin's surface and wonder if these are suture knots or suture ends that are not dissolving. How long will this continue?

Stephen Prendiville, MD · Answer

The areas described all sound like they are associated with the incision line and are highly unlikely to have permanent sutures associated with them. PDS, albeit a longer lasting absorbable suture, should not be a factor at 10 months. The signs and symptoms described require an examination and I recommend you return to your operating Surgeon for further evaluation.

Larry S. Nichter, MD, MS, FACS · Answer

It would be very unusual to have allergic reactions to permanent sutures. Depending on the type of absorbable sutures however the symptoms you describe are not uncommon during the first several months. By a year they should all be resolved. If still there please return to your plastic surgeon as their may be another explanation such as uneven plication of the SMAS layer. The PDS should be absorbed by now for most of the sizes commonly used.Resolving  Numbness is expected after all facelifts.

John Bitner, MD · Answer

Irregularities in the SMAS layer after a face lift can be caused by non-dissolving suture or bunching if the SMAS was plicated. Do you know if the SMAS was lifted and a piece removed?  Any permanent sutures can be safely removed at this point without effecting your results as long as the SMAS was lifted and a piece removed.

Andrew Campbell, MD · Answer

Any suture that dissolves should be completely gone by 10 months. Obviously, permanent sutures don't dissolve, but you shouldn't be having any sort of reaction to them at this stage. Swelling and numbness are normal after a facelift and should slowly improve over 6-12 months. The areas you are describing seem to be along the incision lines and may just be related to your scars maturing. It takes scars about a year to mature, so the timing seems right. I'd recommend seeing your surgeon so the area can be evaluated. I will frequently treat symptoms like yours with a small injection of dilute steroid. It often makes the itchiness, redness, and bumpiness resolve quickly.

Andrew C. Campbell, M.D.

Board Certified Facial Plastic Surgeon

Andrew C. Campbell, M.D.

Board Certified Facial Plastic Surgeon

Frank P. Fechner, MD · Answer

A thorough examination is necessary to answer your questions. PDS sutures are absorbable and should be gone after 10 months. Itchiness in areas of healing is common after surgery but rashes, redness and inflammation is not usually seen at this point. Consult your face lift surgeon for his assessment.

Kenneth Hughes, MD · Answer

The PDS suture should have dissolved by 10 months, but permanent sutures may be an issue. This would be impossible to assess without examining you and knowing exactly what was done during your facelift. Kenneth Hughes, MD Los Angeles, CA

Michael I. Echavez, MD · Answer

It is not unusual to have some itching along incisions as the healing takes place. There normally is some redness along the incisions as well, although this should improve over time. It is possible to feel some of the sutures under the skin. If they were permanent sutures, this most likely will not change. PDS sutures dissolve over time, so those would improve. I would encourage you to see your surgeon, as he or she has the most knowledge about your particular surgery, and so would be the best person to answer your questions.

Algird R. Mameniskis, MD · Answer

What you are experiencing is a common situation. Your body dissolves a suture with a similar reaction that there is in infection. Inflammatory cells are called to the area and these cells break down the stitch. Everyone has this reaction, but some are more intense than others. The process will run it's course in due time, follow your surgeon's advice

Erez Sternberg, MD · Answer

The areas you describe all sound like they are associated with the suture line and are highly unlikely to have permanent sutures associated with them. This may represent local stitch or "suture abscesses" that can develop in areas were sutures once were. PDS, is a longer lasting absorbable suture, but would be mostly dissolved and should not be a factor at 10 months post surgery. The signs and symptoms you described should be thoroughly examined by a surgeon and I would suggest you return to your original surgeon for further evaluation.

Scott E. Kasden, MD, FACS · Answer

It is unlikely you are having an allergic reaction however you may be having a low grade infection or inflammation.  In the areas that you report, dissolving sutures are usually used, but not always.  It is a good time to visit with your ps and talk about getting the offenders out.

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Am I Having an Allergic Reaction to Long Term PDS and Permanent Sutures Used on my Face Lift Performed 10 Months Ago?

Answers (12)

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