Why is stitching uneven ? Will it all flatten up?

Question

I have seen pictures of patients with even stitching with long incision Vs uneven stitching with short incision, ripping and some bunching up at the seams. What do you recommend ? Which one heals faster ?

Jed H. Horowitz, MD, FACS · Answer

It is hard to understand what ‘uneven’ stitching may mean, but I definitely agree with my other colleagues’ answers that a raised incision is helpful, and the stitching should be completed tightly where the slight pleats will be visible for a while during the recovery period. As stated by the others the pleats will go away as the sutures repair and it will smooth out over time.

Sheila S. Nazarian, MD · Answer

Without a photo or better yet, seeing you in person, it is impossible to comment. The best stitches are the ones that seamlessly close together the two sides of the wound with little tension. Best, Dr. Nazarian

Nelson Castillo, MD · Answer

Thank you for your question.  The best stitching is that which leads to a slightly raised incision (everted) with perfectly opposed skin edges.  At times some pleating is required, but these incisions will take a longer amount of time to flatten.  Hope this helps.

Arian Mowlavi, MD, FACS (license on probation) · Answer

There is no such a thing as stitching uneven? You may be referring to pleats that are present at the ends of an incision? This is created by excising an ellipse; it is tighter and thus flatter in the middle and more redundant at the ends thus creating pleats; these pleats will go away over a three to six month period.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and the best stitching aligns the edges of the wound perfectly under little tensionDr Corbin

Edward J. Domanskis, MD (in memoriam) · Answer

In order to smooth out scars and give them the best chance of healing, they need support and in my experience what has worked for my patients is ScaRxTape. I recommend that my patients apply it starting about the 2nd week, after the steristrips come off and continuously for 2-3 months, changing it as necessary or about every week.

Why is stitching uneven ? Will it all flatten up?

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