Upper and lower eyelid surgery. Will dissolvable stitches leave a scar even if they are placed under the skin?

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Although an in-person exam would be necessary to provide a definitive answer, based on the photo you have provided it does appear you would be a suitable candidate for upper blepharoplasty to create a more symmetric crease. During the surgery a small amount of fat will be removed, and your crease will be formed and set at a bit higher. It is a surgeon's preference to use absorbable vs non absorbable stitches. Consult with 2-3 of these surgeons in person and determine your comfort level with their approach, demeanor, and before and after results. For your lower eyelids, transconjunctival lower blepharoplasty with fat repositioning will provide nice results with a hidden incision and a better lid-cheek transition in this case. #drdonyoo

Dissolving sutures can sometimes create additional inflammation as your body gets rid of them. However, they should not lead to increased scarring in the long run. In terms of scarring of the lid, more important is the surgical technique rather than suture type. Most scarring issues come from poor closure and aggressive skin removal.

Upper eyelid scarring is usually very forgiving, even for people with darker skin. I would actually use non-absorbable sutures that you remove 5-7 days after surgery, as these do not cause a reaction with your skin and tissues.