Sutures Not Dissolving on Upper Eyelids?

Question

I had and eyelift and mid-face lift done 9 days ago and things seem to look good except my upper lids which still show redness and swelling where the 'dissolving' sutures are.   What can I do about this? The Dr. does not seem to be concerned about it.

Anil R. Shah, MD · Answer

The upper eyelids are exquisitely sensitive.  The skin around this area can be easily perturbed.  Dissolving sutures have the following distinct disadvantages:

More reactive to surrounding skin
	
		Unpredictable absorption pattern- may dissolve earlier or later than ideal.  If sutures dissolve too late, can cause abnormal scarring such as track marks
	
		Limited in how small suture size-  Due to the fragility of the material of dissolving sutures, they can not make a suture as small in diameter as a permanent suture.

Due to those factors, I do not use dissolving sutures in upper eyelid surgery.  Permanent sutures, which are removed later, are a more predictable choice offering less irritation (some of these sutures are used in heart valve surgery), predictability, and allowing the use of extremely small size sutures.

Andres Bustillo, MD, FACS · Answer

The dissolving sutures can sometimes irritate the skin sometimes. The solution is simple. Have your surgeon remove them.

David J. Levens, MD · Answer

Suture irritation can occur with both non-dissolving and dissolving sutures and is treated by removing the sutures. At 9 days, there should be no problem with removing eyelid sutures, even if they will continue to dissolve on their own. The irritation may be from something else, but at least removing them may solve the problem and if not, help discover what the specific problem actally is.

Stephen Prendiville, MD · Answer

The first piece of advice I will give is : Don't worry, the sutures will be gone very soon.

	The reason I prefer permanent (removable) monofilament sutures for upper eyelid surgery is that there is less initial tissue reaction than with absorbable sutures.  Although the variant of absorbable suture  probably used in your case is designed to dissolve in 6-7 days, it can last longer in certain circumstances.  At 1 year, it won't make a difference because eyelid surgery scars almost invariably heal withe minimal scarring

Vincent N. Zubowicz, MD · Answer

Your upper eyelid sutures might need removal. Ask your surgeon. If they are the dissolvable type, depending on the material used, it may take a bit longer for them to disappear. I would call your surgeon and get the information.

John M. Hilinski, MD · Answer

If your surgeon used dissolvable sutures along the upper eyelid incision, you might be seeing the reaction of your skin to the dissolvable material. For instance, there is a material called fast absorbing gut that is commonly used as a dissolving suture. The benefit is that you do not have to remove the suture.

Unfortunately, the tissue reaction that causes the sutures to dissolve on their own can create just what you describe - some redness and mild swelling. This is the precisely why I do not use absorbable sutures along the upper eyelid if possible. A non-absorbable suture is better in my opinion because it leaves a finer scar both initially and long-term. Assuming there is no infection of the eyelid incision (which is quite rare), your healing should continue to get better on its own.

Happy healing.

Farhad Rafizadeh, MD · Answer

Usually non desolvable sutures are used after eyelid surgery. These sutures are removed within 5 days otherwise there is tendecy to form cysts. The redness could still be du to echimosis in which case it will go away. The scars can be red and this redness could resulve in months. You should follow up wth your plastic surgeon.

Tanveer Janjua, MD · Answer

The removable sutures can cause some irritation at times. If you are concerned you can ask your surgeon to remove the sutures.
However the swelling and redness is likely from the midface lift and not from the sutures. Midface lift can cause longer swelling.
Also, keep in mind that if you are still using Neosporin ointment on the eyelids, this could be an allergic reaction.
Regards

Jeffrey Weinzweig, MD, FACS · Answer

It is perfectly fine to use permanent sutures, such as Nylon, which are easily removed 4-5 days following surgery, or dissolving sutures, such as fast-absorbing gut, which usually dissolve in 5-6 days.

Raghu Athre, MD · Answer

9 days is a bit long for upper eyelid sutures. You might want to touch base with your surgeon once again. If they look like fishing line, they might be nylon sutures that need to be removed. If they are brown/clear they might be absorbable fast absorbing gut that that should have dissolved by now.

Sutures Not Dissolving on Upper Eyelids?

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