Are Permanent Sutures Better to Use when Rotating Tip? Why?

Why are permanent sutures better/worse than dissolvable sutures when rotating tip? What are advantages/disadvantages of each? Thank you!!

Doctor Answers 9

Are Permanent Sutures Better to Use when Rotating Tip? Why?

 Whether used in Rhinoplasty , Face Lifts or Breast Augmentation...permanent sutures do not dissolve while dissolvable sutures do.  Once the suture is dissolved, the ability to hold things in place resides solely on any scar tissue that has been formed.  IMHO, better to rely on the permanent suture.

Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Suture technique in rhinoplasty surgery

If your surgeon has experience in rhinoplasty surgery he will select the best suture and suture technique to achieve the best optimal result.  I generally use a permanent prolene suture but the newer absorbable sutures are a viable alternative.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Permanent sutures in rhinoplasty

I've always used permanent sutures because it just makes me feel more secure. I can't honestly say however that it any "better" than absorbable sutures. You should not be making your decision on this though. Avoid micro managing your surgery. Choose your surgeon based on results, availability and good old fashioned bedside manner that you can relate to. Then let your surgeon do the rest.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 77 reviews

Permanent vs. Absorbable Sutures for Tip Rotation

The use of permanent versus absorbable sutures has been debated for many years. Most of the time it does not matter, but there have been some cases where the permanent sutures have been rejected and must be removed. With the newer longer lasting absorbable PDS sutures this has become less of an issue. These sutures seem to last long enough to form permanent scar attachments to preserve the new tip position.

Ira D. Papel, MD
Baltimore Facial Plastic Surgeon
4.9 out of 5 stars 31 reviews

Tip rotation

 Tip rotation is accomplished with multiple different techniques in the nose during the rhinoplasty procedure.  Suturing the tip cartilages together is one technique that is used to help with rotation. We used dissolvable stitches not permanent sutures due to small stitch infections it can occur in permanent sutures. If an infection occurs in the permanent sutures, a revision surgery will be necessary to remove it.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Permanent sutures in rhinoplasty have pros and cons


Good question.  Permanent sutures allow a stronger longer lasting hold but the disadvantage is that you may end up with a great result but months or years later the plastic sutures may get infected and you may need another surgery to go fish them out.

Personally I do not like any plastic in the nose and permanent sutures are a form of plastic.

Shervin Naderi, MD, FACS
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 106 reviews

Permanent sutures for tip rotation

Many surgeons use a permanent suture for tip rotation and shaping, some an absorbable suture. Tip rotation is also possible without any suturing at all depending on other ways the tip cartilage can be modified. Worry more about a well qualified surgeon who listens rather than what suture might be involved.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Permanent Sutures in Tip Rotation

With all due respect I suggest that you not worry about technique but select an experienced surgeon. Both types of suture are acceptable. Many surgeons use both depending on the needs of each patient. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Permanent vs Absorbable Sutures for Tip Rotation

     The argument for permanent suture is that you are not relying upon the scar to hold the framework.  The argument for absorbable is that you will not have to deal with suture exposure, palpability, or abscess long term.  Either is acceptable.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.