Is 11 days excessive for time in sutures after upper blepharoplasty?

Question

I had upper and lower blepharoplasty, and the surgeon did not remove the sutures for 11 days. By this time, my skin was having a severe reaction to the sutures and my recovery was quite delayed from the amount of time in sutures. I had the feeling that I was moved from 5 days to 11 days because of the surgeon's busy schedule. It felt excessive. My question is, is it considered good practice to keep a patient in sutures for this long ? Is there increased risk of permanent scarring ?

David W. Rodwell III, MD · Answer

In almost every situation I remove eyelid sutures at about 4-5 days after surgery.  The closure of a blepharoplasty incision should have minimal tension, and the thin eyelid skin heals remarkably quickly.I always use sutures that have to be taken out (nylon monofilament).Absorbable sutures may or may not cause more inflammation.  I feel that they usually do.  However, what is clear is that the sutures are rarely completely dissolved within one week, so the remaining parts of the dissolvable sutures still need to be removed.11 days is much too long in my opinion, but I cannot speculate as to whether or not that was proper without knowing the details of your procedure and why or why not there may have been a need for a delay in suture removal.

Peter N. Butler, MD, FACS · Answer

We typically remove sutures within 5-7 days in facial areas, especially the eyes. However, leaving the sutures in a few more days should not effect your final result.

Luis M. Rios Jr., MD · Answer

Blepharoplasty sutures can usually be removed safely from 7-10 days. 11 days is probably on the upper limit of the time frame, but some patients require that time to prevent the incision from opening. The dilemma in eyelid surgery is to try to remove the sutures as quickly as possible to reduce the possibility of a scar vs. removing the sutures too early and having the incision open up. If sutures are left in too long they can cause suture marks along the incision. Sometimes the scar resolve on its own and sometime the scar needs a small revision. 
My advice is to remain patient and continue to follow up with your surgeon. If the scar hasn't improved significantly in 3-6 months, you could inquire about a scar revision.
Good Luck!

Kenneth D. Steinsapir, MD · Answer

Surgeon inconvience is absolutely not an excuse for not removing sutures in a timely manner.  Taking the sutures out at 11 days will probably not cause long term problems. Occasionally one will see milia or suture cysts but that can occur even when sutures are removed earlier.  I do see an increasing trend for surgeons to place absorbable sutures in the skin with the mistaken impression that these will simply dissolve and the surgeon won't need to remove the suture. That is far from reality.  While there are sutures that absorb very quickly, they do not always do so. Many of these sutures simply don't breakdown on their own and need to be removed at 5-6 days.  Thank you for posting here so others recognize that it is not ideal to leave sutures beyond this time frame.

J. Timothy Heffernan, MD · Answer

Thank you for your question. Typically, I remove sutures after blepharoplasty anywhere from 6-9 days after the surgery. I don't believe leaving them in longer in your case with jeopardize your final result. Best of luck, Dr. Heffernan

Robert Brueck, MD · Answer

This is every surgeons choice.In bleph surgery I usually will remove them in 7 days or less but each surgeon is different.In the end I don't think it will compromise the result.

Richard Sadove, MD · Answer

I personally do not leave upper eyelid sutures in place for 11 days. I remove upper eyelid sutures after 5 or 6 days.

Paul Nazemi, MD · Answer

Thank you for posting your question.  There is a general range of suture removal after blepharoplasty.  Although you are on a slightly longer end of that range, you should do well.  There is no long term increase risk of permanent scarring.   Follow up with your doctors post operative instructions and best wishes.

Byron A. Long, MD · Answer

Your question has many variables that weren't presented. The type of suture?do you have a history of keloid formation? Was it a true allergy to the suture? Your surgeon would know the answers to all of these and I would definitely ask him/her. But overall we usually take them out at 8 days and I use a nylon or prolene type suture, so I don't think 11days is going to cause any long term scarring. If it was an allergy to the suture or something else I would place you on some oral prednisone to reduce swelling and redness. If at a month there is some scarring a steroid and antifibrotic agent can be injected in the area. I wouldn't be overly concerned at this point but definitely see and ask your surgeon,  it is their job to take good care of you after a surgical procedure.

Is 11 days excessive for time in sutures after upper blepharoplasty?

Answers (9)

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