Sutures or staples behind the ear? Does it really matter?

Dear DinaTelli-The staples sound scary but actually are BETTER in the hair-bearing skin.  And importantly, they're easier to remove (less pain for you!).  The incisions directly behind the ear, in the non-scalp skin, are treated with traditional stitches.  If for some reason a patient really does not want the staples, we can always use regular sutures. 

Both sutures and staples can yield
an equally beautiful result. The real deciding factor is your surgeon’s skill
and comfort with the closure he chooses. Ask to see photos of his/her incision
lines as the heal, that will give you the reassurance you need to feel comfortable
with the closure he/she typically creates. My preference is to use very fine
sutures.

Thank you for your question.Staples tend to be gentlier to a hair follicle so they are used in the hair-bearing scalp region, so in the scalp above and behind the ears; otherwise, most of us use many very small and fine stitches along all the other skin incisions.Hope this helps!

Best regards,Dr. Marc DuPere, Toronto Aesthetic Plastic Surgeon

Staples should only be used in the hair-bearing areas while sutures should be used on the skin. Typically, staples are used in the part of the incision that hides inside the hair.

Thank you for your question.  If the staples are in the hair, then it probably wouldn't make a difference, but if it is non hair bearing skin, then definitely sutures.  If staples are placed in non hair bearing skin for some reason then they should be removed rapidly.  My practice is to use sutures for everything to give the best cosmetic result.  All the best, 

Any staple has a large caliber which creates more damage to the skin then will play sutures. I personally do not use them and would discourage any other plastic surgeon from doing so.

As a plastic surgeon I just have a problem using staples to close incisions. However, if the incision is in the hair it probably doesn't really matter. If the incision is in the skin right behind the ear I do think that it makes a difference. Stables can leave marks on either side of the incision known as railroad tracking. I also feel that staples leave a thicker scar. Small buried dissolvable sutures, in my practice, leave a much less noticeable incision. 

I prefer sutures for facelift closure in non-hair bearing skin.  Staples are OK for areas, like the scalp, where there is lots of hair.  The keys to a good scar are neatness, avoiding tension on the closure, and a little luck in terms of patient genetics!All the best,

What matters in terms of scarring is "tension".  If the flap is too tight it wants to spread apart and can widen the scar.  Even worse, too tight of the skin flap can affect tissue healing.  Skin closure of the facelift flap should just "kiss" the edges, how you "secure" the edges using sutures or staples especially behind the ear is a matter of preference; staples are quicker, removing either should not cause too much discomfort.  For me, in general, I staple the mastoid and hairline region "behind the ear"; but the firm "cartilage portion" behind the ear, I use sutures because I do not want to injury the cartilage of the ear.

 Communication with your surgeon is of the utmost importance and is very important that you ask your surgeon where the incisions are in front AND behind the ears. Most surgeons use a combination of sutures and staples in front and behind the ears for a face/necklift procedure. These are the type of questions  that get answered at the pre-operative consultation.