Can Internal Stitches Work Their Way out After a Face Lift?

You may be right in your analysis. From what you described you have a "spitting stitch". Essentially your body tends to push foreign bodies to the surface and once it comes in contact with the pores or skin surface it can become inflamed or infected and may cause what is called a suture granuloma.

Most important is that you need to see your plastic surgeon for evaluation and treatment.Do not delay.

 It is difficult to know the answer to this without consulting your surgeon. Some surgeons use very long-lasting absorbable sutures to hold up the underlying tissues (The SMAS)  in a facelift, while most use non-absorbable  polyester signatures. These can very rarely erupt through the skin. In any case you should consult with your surgeon as he or she would know what type of suuture was used 

  This could be a suture abscess or irritation, and this could have been used for SMAS plication or the like.  An exam by your plastic surgeon will be necessary.  Kenneth Hughes, MD Los Angeles, CA

The simple answer to your questions is "yes"; internal sutures can become inflamed and work their way out after surgery.  This can occur weeks, months, or even years after surgery.  In my experience, this process is more likely to occur when braided sutures are used.  Many Surgeons prefer a longer lasting form of deeper suture, such as a braided Nylon, or a PDS (monofilament) for fixation of the SMAS.  In my experience, this circumstance is most likely to occur when a braided suture is used in a male patient.  The high density of deeper hair follicles in relative proximity to the suture is likely to account for this.  Removal of the offending suture(s) is usually sufficient to solve the problem.

Dear Barty1-

 

Depending on your facelift technique, you may have sutures under your skin, in the area in front of your right ear, as you describe.  These sutures may be absorbable, or may not be, which also affects how quickly they dissolve.  

Generally, treating this type of issue can be done safely in the office, using some local anesthesia, and either removing the suture, re-suturing the right ear area, getting a possible cortisone injection, or a completely different technique, depending on what is going on with your right ear.  

 

Only a physical exam with your plastic surgeon, in person, can fully determine what's going on with your right ear, so I would suggest seeing him/ her as soon as you can.

 

Best Wishes on a Speedy Recovery!

 

Roy Kim, MD