How long for outside sutures?

Question

why would removal of sutures behind ears be delayed until three weeks after mini face/ neck lift. The ones in front were removed at one week.

Jonathan Kulbersh, MD · Answer

Sutures behind the ear are typically resorbable so they do not need to be taken out.  If permanent stitches are used in the area, they are typically removed 1 week after surgery.  Then can be kept in place if there is a concern about healing in the area.  I would ask your surgeon why he is delaying removing your stitches.  I am sure he will be happy to answer this question.I hope this helps.

John Michael Thomassen, MD · Answer

The sutures behind the ears are not removed early since scarring in this area is not that objectionable.  Many times absorbable sutures are placed in this area and they area allowed to resolve on their own.

Garrett Griffin, MD · Answer

I can only answer for myself, but I remove the non-absorbable sutures in front of th ear at 1 week and leave the sutures behind the ear to dissolve on their own.  The reason for this is:-sutures left in place for more than about 10 days start to leave creases in the skin, called "track marks," so I want the non-absorable sutures in front of the ear out before these start forming.  But I also want the wound to be stable enough that it won't open up when the sutures are removed.  7 days appears to be the "sweet spot" where the wound is strong enough to have sutures removed, but before track marks form-The portion of the facelift incision behind the ear has more tension on it.  Thus, it may take longer to become stable enough to exist without stitches in place.  It is easier to use absorbable stitches behind the ear because it is a difficult and sensitive area to remove sutures from after a facelift...hair is in the way, etc.  Plus, you don't want to be tugging on the ear so that you can see behind it to remove stitches in the early postoperative period...tugging can be painful for the patient and can disrupt the portion of the incision in front of the ear.  Some patients do complain about the stitches behind the ear, and so in these patients I will remove the absorbable stitches, but most patients don't notice them and they just dissolve on their own within 3-4 weeks.

Evan Ransom, MD, FACS · Answer

Generally, the sutures from a mini-facelift are removed between 5 days and 10 days after the surgery. I typically remove the ones in front of the ear first, then the ones behind the ear. I have not, personally, left the sutures in place for 3 weeks. You will need to ask your surgeon directly -- there may be a good reason.

Elizabeth Whitaker, MD, FACS · Answer

Thank you for your question.  Sutures are usually removed earlier than three weeks if they are not dissolvable.  It is possible that your surgeon placed dissolvable sutures behind the ear.  However, sometimes sutures can take longer to dissolve than typical.  I would contact your surgeon and ask if the sutures are dissolvable, and when you should come in if they are not dissolving."This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Bhupendra C.K. Patel, MD, FRCS · Answer

There has been some change in thinking about skin and subcutaneous healing over the last few years. Traditionally, all sutures on the face used to be removed at 10 days. Without going into the biomechanics of skin and tissue healing, we know that the strength of skin and deeper tissue wounds does not improve to an acceptable level within five days. Indeed, even at 45 days, there is evidence that the skin tensile strength is only 50 - 75% compared to normal skin. Therefore, removal of skin sutures early when there is no tension is reasonable (in front of the ears, in your case).There is frequently some degree of tension (more than elsewhere), behind the ears. Surgeons who say their facelifts have no tension anywhere are more wishful. It is the nature of healing in a face when we walk upright, there is downward traction from bruising, fluid collection, gravity, etc, that some degree of tension is going to be there.To that end (sorry about the long answer), many surgeons, besides closing wounds in layers, will leave sutures in certain parts of the body (including the post-auricular incisions in a face lift), for several weeks. Your surgeon will have a logical explanation of this: talk to him!!Good luck!Prof. Bhupendra C. K. Patel MD, FRCS

Gustavo A. Diaz, MD · Answer

Surgeons will have different ways and techniques. This also is true for the amount of time that they leave a suture. I personally use dissolvable sutures in front and behind the ear; therefore I do not have to come back to remove sutures and create more discomfort to the patient. Call your physician office and make sure if you have dissolvable sutures or sutures that will need removal at some point.Hope this helps.Dr. Gus Diaz

How long for outside sutures?

Answers (7)

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