Lip laceration and suture removal, is this correct?

Question

I had a full thickness laceration to my top lip due to blunt trauma. It was sutured by a plastic surgeon, at six days he removed the sutures toward the top of the laceration near the vermilion boarder. However he stated he wanted to leave the lower sutures in until they fall out on their own. They were a diffrent type of suture but seems contrary to what I know.

Benjamin Caughlin, MD, FACS · Answer

There are many different types of sutures. Synthetic, organic, permanent and absorbable. The permanent ones need to be removed (likely the ones he used at the top). The lower ones absorb and weaken overtime as the body breaks them down. It is a delicate balance of having enough support to the tissues and not leaving them too long to leave tacks. The plan sounds reasonable. Obviously the only way to know is to have the exact suture type.

Best of luck,

DrC

Best of luck,

DrC

Nicholas Jones, MD, FACS · Answer

Thank you for your question. Meticulous repair and expertise is important for repair of lip lacerations because improper repair can lead to poor results. More importantly, the lips are a focal point of the face and inadequate repair can be easily noticeable. When performing repair of lip lacerations, the vermillion may be re-approximated with absorbable suture. The vermillion border (white roll), is usually repaired with a nonabsorbable suture to ensure the alignment is maintained. The nonabsorbable suture should be removed within 4-5 days to prevent permanent suture marks.

Good Day,

Nicholas Jones, MD

Good Day,

Nicholas Jones, MD

Kapil Saigal, MD, FACS · Answer

It sounds like the Dr. wanted to remove the permanent stitches in the skin and let the dissolvable sutures in the mucosa (the pink part of your lip) dissolve on their own. That sounds like a reasonable plan, as mucosa heals much better than skin with minimal scarring, and he probably wanted to support the area as much as possible while it heals since lips are in constant motion. Discuss this with your surgeon but sounds like a reasonable plan. Best of luck.

Inessa Fishman, MD · Answer

The inner/ mucosal lip is frequently repaired with absorbable sutures; these are typically not removed, as they tend to come out on their own.  This may be the case with your repair.  Check in with your plastic surgeon for clarification, and good luck with your healing.

Lip laceration and suture removal, is this correct?

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