What is the pebble under my skin where stitches were?

Question

So I am 4 weeks post upper blepheraplasty and on my left eye where the stitches ended is a lump that feels like a rock or pebble inside the skin. I've been massaging it but it doesn't seem to be going down at all. My dr is away until march 8th which is when my follow up appointment is but I would like to know if this is normal, what it is or could be and treatment to remedy it.

Dilip D. Madnani, MD, FACS · Answer

Small bumps after upper and lower eyelid surgery are very common, especially within the first few months after surgery. The eyelid skin is very thin and sometimes small cysts/milia/scar tissue develops that subsides over time. Your doctor will recheck it and let you know what is going on.

Erik Miles, MD, FACS · Answer

It is difficult to say without a picture or examination, however it could be a buried suture or a small cyst that sometimes can form along the suture line.  I do not typically use buried sutures on a blepharoplasty, so I'm more inclined to think that it is a small cyst that can be easily treated by your surgeon.  I would leave it alone until your follow up appointment. Best wishes to you!

John Paul Tutela, MD · Answer

Thanks so much for reaching out.   You were feeling is likely a stitch that is not dissolved.  It should go away over time or may come to the surface.  Sometimes a cyst forms and may need to be excised. I hope this helps :-)

Jason D. Bloom, MD, FACS · Answer

I would definitely follow-up with your surgeon to make sure everything is ok, but it sounds like it could be a milia.  These occur along the suture line after surgery and are small inclusion cysts that form.  They can usually be treated in the office with a small procedure to excise them.  Either way, your surgeon should be able to take a look and figure out what is going on.

Joel E. Kopelman, MD, FACS · Answer

Occasionally epithelial inclusion cysts occur. The risk of suture granuloma formation is decreased by the use of certain sutures which must be removed completely at the appropriate time. The most common reason for small lumps occurring along the eyelid incision is due to lymphatic fluid retention or a small amount of scar tissue. In the period immediately following the operation, the scar tissue is usually raised and feels firm. Over, the next 3 months or so, the scar will mature and soften. Usually, intervention with this is not required; these scars respond well to routine scar treatment like moisturising creams and silicone gel. Occasionally, a small dose of cortisone injected into the scar which would help break up these small, hard lumps. A lump or granuloma sometimes forms as a reaction to suture material used in eyelid surgery.You can consult with your doctor about it if it causes discomfort.

Dan Landmann, MD · Answer

It is common for something called “suture granulomas” to form where the sutures are. This is nothing bad, in fact it is a normal body response. All it is are some inflammatory cells that surround the suture. These go always away on their own, some take longer than others. Some things you can do to help that are gentle massages in the shower or steroid injection.
I would suggest seeing an oculo-plastic surgeon, which is an ophthalmologist with a concentrations in plastic surgery specifically around the eyelids, if you decide you want to try remedies to help them go away faster.

Leon Goldstein, MD · Answer

This is most likely an inclusion cyst. It should resolve on its own. After 9-12 months if the cyst is still present then an in office procedure can be performed. Massage and stay patient.

Katrinka L. Heher, MD · Answer

This is most likely an inclusion cyst that is created when the suture is pulled through the skin.  I always recommend waiting to see if these resolve on their own but if they continue a simple little in office procedure will take care of it.  Time is on your side so no worries.

Adam Goodwin, MBBS, FRCS(Plast) · Answer

so I use a long acting dissolving suture in this operation which can take 3-4 months to dissolve away completely. I am pretty sure this is what you are feeling. Dint worry about your surgeon being away. Give it chance to settle and see him when he gets back. Hope that helps, Adam Goodwin

What is the pebble under my skin where stitches were?

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