For a lower facelift, what is the advantage/disadvantage of having staples versus stitches in the scalp?

Question

I’m interested in a neck lift lower facelift. I am noticing some doctor are using stitches in the scalp and others are using staples in the entire scalp. Is one better than the other? Advantage/disadvantage? I feel like using staples is the old way of doing a lower facelift and takes way longer to heal because you have to use head bandage for a month and have to wait this long to color your hair too.

Toby Mayer, MD · Answer

Having used staples in the scalp for more than 45 years and 20,000 patients without any difference for sutures and no difference in the final scar I see no difference! Of course with either method the wound must be closed before skin closure to make it a TENSION FREE closure.

Lucian Ion, FRCS · Answer

Thank you for your question.

In general terms, there is little difference between the healing process with staples or stitches in the scalp. Staples do not fully close the loop and are considered by some to be more protective of the hair follicles. It is sometimes easier also to adjust the hairline behind the ear using the staples and produce a more natural appearance.

The time it takes for the healing process and the time before you can color your hair is more related to the natural processes of wound healing.

Wearing the bandages is essentially about swelling rather than the wound healing process on the wound edges. And this is an individual recommendation depending on the patient characteristics and the surgeon's experience and preferences.

David Hansen, MD · Answer

staples are quick and easy and annoying to have but docs who like to take shortcuts, still use staples.

Alan B. Brackup, MD, FACS · Answer

We use a combination of staples and sutures... we use staples in the hairline and fine sutures elsewhere. We also do not use any facial bandages past 24 hours. I would say it is surgeon preference.  Good luck.

Tanveer Janjua, MD · Answer

Stitches are more precise in approximating the skin edges and lead to better healing. Staples are quick to do and save time during a facelift.RegardsDr. J

Michael P. Morrissette, DDS, FACS · Answer

Staples are commonly used in the hairline portion of the incision and there is no discernible difference in the healing. It is best to discuss your concerns with the surgeon.  if your surgeon usually prefers staples but you would prefer sutures, it is not a problem for the surgeon to allow sutures to be placed in your case.

Brian K. Machida, MD, FACS · Answer

As long as the staples are entirely in the scalp and not at the junction of hair bearing to non hair bearing areas, there should be no difference in healing.  Non hair bearing areas of skin require finer suture for a better result.

William Portuese, MD · Answer

In our practice, we use staples in the hair, and fine sutures everywhere else. More importantly is to not place any tension on the skin which will give wide scars. We also removed the staples early in the healing process to help try to prevent any additional scarring as well.

Robert Singer, MD · Answer

Good results can be achieved with either result in the appropriate patient. What is more important than the specific technique is the experience and artistry of the plastic surgeon.
 
 I would suggest your  plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with whohas all of the modalities of treatment available. You should discuss your concerns with that surgeon in person.
 
 Facial rejuvenation needs to be individualized. What would be an ideal approach for one patient is not necessarily the same for someone else. Based on the examination and discussion at the consultation, you should have a better understanding of the various options that can achieve the best cosmetic result for you.
 
 Robert Singer, MD FACS 
 
 La Jolla, California

Sutton Graham II, MD · Answer

Both staples and sutures can give quality scalp scars when done well.  My preference is a combination of buried absorbable sutures and nylon surface sutures which are removed during early postop visits.  Surgical staples can approximate the scalp nicely, and can be less time consuming.  Our postop dressings and care routine would be the same regardless of the scalp closure method.  It sounds like you are doing your careful research to select the best facelift plastic surgeon, which is excellent.  I would suggest other factors as to their skill, care and results are more important than the scalp closure method they use.  Best wishes on your search.

For a lower facelift, what is the advantage/disadvantage of having staples versus stitches in the scalp?

Answers (10)

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