A quill suture poked through my armpit incisions after brachioplasty, now concerned over other areas. What should I do?

Question

2 months PO Brachioplasty; a week ago a quill suture popped out of the botton of my arm pit incision and got stuck. It was agonizing; hurt TERRIBLY, but it did come out. I feel other sutures trying to poke through the upper part of the incision but aren't quite there; should I go back to my surgeon before my next appt (in about a month) or wait to see if they pop out? They are right at the surface. I'm afraid they'll be more painful quill sutures.

Yannis Alexandrides, MD, FACS · Answer

The stitches are deep but can come to the surface of your skin. If you find them very painful you should follow up with your surgeon who could remove them for you.

J. Timothy Katzen, MD, FACS · Answer

Hi, TrickOfTheTail in Asheville. Thank you for your question regarding a quill suture that poked through your armpit incisions after your brachioplasty and what you should do.  Most experienced plastic surgeons on not use quill sutures because the quill sutures are painful, often rejected, lead to suboptimal healing, and deliver poor overall scar appearance.  Fortunately, the quill sutures used for the arm lift are dissolvable; therefore, your brachioplasty or arm lift quill sutures will eventually dissolve.  Most plastic surgeons would not remove the remaining quill sutures in your arm if there are no problems. First, two months after an arm lift, the arm lift tissue is not healed enough to support the closure of the incision without sutures in place.  Second, removing the quill sutures is not indicated since you are not having active problems with the quill suture. Active problems include complications like infection, wound opening, and visible and or palpable quill sutures.  Worrying about possible future pain from a quill suture is not an active problem. The thought pattern for most plastic surgeons would be, "If it ain't broke, don't fix it."  The cure or treatment (removing the quill arm lift sutures) may be worse than your current situation. Good lick.  Thank you for your question regarding a quill suture that poked through your armpit incisions after your brachioplasty and what you should do.
Since a brachioplasty or arm lift surgery is difficult, please seek an experienced, board-certified plastic surgeon with significant experience performing these types of arm lifts. Do your research.  Make sure your chosen plastic surgeon has performed at least 100 arm lifts.  Make sure they have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   Sincerely, Dr. Katzen, MD, MBA. (Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Aldo Guerra, MD · Answer

I'm sorry to hear about your experience. You should absolutely see your plastic surgeon and address your concerns. I'm not sure that any more sutures will poke out (most likely), but having a professional take a look and examine you is the way to go!Best wishes, Dr. ALDO

Gary L. Ross, MBChB, FRCS · Answer

I would ask your PS about whether the quill's are dissolvable or not. It is unusual for quills to come out prior to them dissolving. Often surgeons not only use quills but also use some interrupted dissolvable stitches and it may be these that you are now feeling. Best to see your PS and be advised.

Mark H. Peters, MD · Answer

This is a good question. The most common area of the suture that is exposed is the knot that either ends or starts a new segment. It is not uncommon to have this happen and going to your surgeon is probably your best bet. Occasionally surgeons use permanent sutures so these must be removed before healing will proceed.  Bottom line...don't wait for a month to have these issues addressed.

A quill suture poked through my armpit incisions after brachioplasty, now concerned over other areas. What should I do?

Answers (8)

Answer: Quill

Answer: Quill

Answer: Exposed sutures

Answer: Exposed sutures

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Everything you need to know about Arm Lift

Our mission is to create a world where every investment in modern beauty is Worth It.

A quill suture poked through my armpit incisions after brachioplasty, now concerned over other areas. What should I do?

Answers (8)

Answer: Quill

Answer: Quill

Answer: Exposed sutures

Answer: Exposed sutures

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Recommended reading

Everything you need to know about Arm Lift

Our mission is to create a world where every investment in modern beauty is Worth It.