Concerned about suture spitting. How common is spitting and how will it affect my breast lift?

Question

I’m getting a breast lift before the end of the year and I’m worried about suture spitting. I had a mole removed on my shoulder some years ago and I ended up with a big angry scar because of spitting. I explained this to my surgeon during the consult and she didn’t seem too concerned about it. She said she could give me injections to stop the spitting if it happens. My question is, how common is spitting and how will it affect my breast lift?

Luis A. Mejia, MD · Answer

hello thank you for your question and provided information as well.. based in your question its difficult evaluate you if the case dont have a picture, its recommended if you get a consultation in person with a plastic surgeon to discuss all about theme.

Daniel Barrett, MD · Answer

Hi melissaw22, 
  
Breast lift surgery aims to re-volumize the breast with either and natural implant or fat grafting followed by nipple repositioning using the lift. I prefer to use a vertical incision (lollipop pattern) breast reduction technique instead of the anchor scar pattern for more significant lifts. This reduces more noticeable scarring than usual. Mastopexy that requires less than 2cm of lift only needs a donut incision. Every incision is also closed in five precise layers without using reactive sutures that can cause inflammation and eventual scarring.
  
If you are considering a breast lift, you should consult with a board certified plastic surgeon to discuss your options and make sure your surgeon understands your goals. Only after a thorough examination you will get more information and recommendations.
  
Daniel Barrett, MD, MHA, MS
  
Certified, American Board of Plastic Surgery
  
Member, American Society of Plastic Surgery 
  
Member, American Society of Aesthetic Plastic Surgery

Robert P. Schmid, MD · Answer

Thanks for your question! In my experience of doing thousands of cosmetic breast surgeries, the way plastic surgeons sew up the breast tissue, rarely to stitches spit. I think that newer techniques like Insorb staplers and Quill sutures help to minimize this from happening.  In the rare case that they do, they’re usually easily removed, & cause little to no scarring. We are right down the road from you in LBK with our own AAAASF accredited OR, if we can be of further help. Best of luck to you!

Milind K. Ambe, MD · Answer

Thank you for your question.  Spitting sutures can happen but usually they do not cause any subsequent scarring issues.  Unless you have a severe reaction to the sutures, where your body actually tries to get rid of the suture and your entire incision opens up, there shouldn't be an issue with scarring. Make sure you communicate this concern to your surgeon as certain sutures are less reactive than others.

Robert H. Hunsaker, MD · Answer

We certainly see this from time to time. We do things technically to try to prevent this. Typically, at it's worst, it can leave a wider spot on the scar after healing. If this is bothersome, it can be revised (usually under local anesthesia) after an appropriate amount of time has passed.

Jorge Jiménez Toribio, MD · Answer

Hi dear, thank you for your question.It shouldn't be a problem if the sutures are done correctly however it may happen to every patient. It depends also on the doctor's practice and how your body reacts during the healing process. You should consult your PS about it before getting under surgery.Hope this helps!Dr. Jiménez Toribio Plastic and Reconstructive Surgeon.

Jon Ver Halen, MD, FACS (license suspended) · Answer

Dear Melissaw22,Hello and thank you for your excellent question.  You may want to look into the Bellesoma Breast Lift technique - it provides an exceptional breast lift, upper pole fullness, relief from neck and back pain, and no vertical breast lift scar. It uses a woman’s OWN breast tissue to produce an internal suspension technique, without the need for a breast implant. It does not disturb the nipple, areola, or breast glands, so sensation and the ability to lactate is preserved. It uses 3D scanning of your breasts and body to design a procedure specifically designed for YOU, and you alone. With regards to suture spitting, given that the incisions are smaller, you have less risk of this occurring.  It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!
  
Best,
  
Jon Ver Halen, MD FACS
  
Harvard educated plastic surgeon
  
Texas “Top Doc” 2017, 2018
  
RealSelf100
  
America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 - 2018

Ronald V. DeMars, MD (Retired) · Answer

Vicryl sutures just under the skin have a much higher incidence of spitting. We rarely ever see the problem with monocryl sutures.

Melih Erogul, MD (retired) · Answer

Hi and welcome to our forum!
Sutures are made of many materials, including absorbables such as synthetic polyglycolics and polydioxanone, or natural fibers such as catgut (from sheep intestine...no cats), and non-absorbables, such as nylon, polyester, polypropylene, silk, and even stainless steel. 
Absorbable sutures will either dissolve (as they are supposed to) or the body will expel the foreign material before it can be absorbed. The suture will come to the surface as a small bump, which may be irritated, and may open with release of discharge and a piece of suture to the surface. 
Certain individuals are more prone to this phenomenon and an individual may demonstrate a hypersensitivity to certain suture materials.
I recommend you try to learn from your previous treating physician the type of suture utilized in the closure.....and then have your surgeon use something else!
Best wishes...

Concerned about suture spitting. How common is spitting and how will it affect my breast lift?

Answers (9)

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