Can Face Lift Fail Because Sutures Are Absorbed to Quickly?

Yes, absorbable sutures absolutely work! Personally, I only use absorbable sutures. By the time they melt away (about 3 months or so), the facial tissues have found their new place and don't rely on stitches holding everything up. Inappropriate would be fast-absorbing sutures (such as gut sutures) but do not think your surgeon would use this suture material for a facelift.

Therefore, I doubt your disappointment is a result of sutures failure. If your before and after photos do not show a difference, then it rather represents a technical issue related to surgery.

The face always looks a little tighter initially (first 2 to 3 months) but the result truly counts after 9 - 12 months. Your experience is one that we sometimes hear after thread-lifts, silhouette lifts or mini-facelifts. I would talk to your surgeon.

Though possible I doubt that in most cases the type of sutures matter. I have been doing facelifts for more than 25 years. I started with permanent sutures in the SMAS then switched about 13 years ago to absorbable sutures and have noticed no difference. The skill of the surgeon, technique, elasticity of the skin and SMAS, general health of the patient, smoking history, all play a role in the final results and their longevity.

Although I use permanent sutures, I feel that long-lasting absorbable sutures also provide a lasting support as the scar tissue is eventually what holds the lift up

Suture breakage or failure would be an uncommon reason for a facelift to fail.

In principle, when we do a facelift, we have to:

1)  free up the SMAS and skin appropriately

2) fully release tethering ligaments which prevent the tissues from moving,

3)  reposition the SMAS and skin appropriately, (back to where it used to be)

4)  hold them in the right positions until it all heals.

5)  hope that the tissue quality is sufficient to maintain this result.

Of all of these steps, #4 is the easiest.  I suspect it was something in the other 4 areas that might have been a problem.

I suspect the problem in your facelift is from one of the other steps.

I personally don't feel that the type of suture is all that important. Once the deeper tissue is lifted, it only has to stay there a few weeks before the healing process will keep it there forever. More than likely, a technique of facelifting was performed that was inadequate for your particular anatomy.

I would recommend discussing your concerns with your surgeon. If a better technique is available, consider a revision facelift. If there is only one technique that surgeon performs, you may want to get a second opinion. There are some very advanced tecniques of facelifting that can create very elegant necklines, even in very challenging patients.

Andrew C. Campbell, M.D.

Board Certified Facial Plastic Surgeon