Scarring, stitches in too long

Question

I had ptosis surgery on July 6th Doctor wouldn't remove stitches , I was very concerned because I felt they were in too long I voiced my concern twice He said the stitches dissolve July 18th, the stitches were still there , my eyes were red , stiff , aching . I cut them out ,felt better . I know but my surgeon would not , the stitches had been in for 12 days I get keloid/hypertrophic scars easily They stitch looks like a train track ,raised red bumpy scars are hard / extremely stiff

Kenneth D. Steinsapir, MD · Answer

They are laboring under a lack of information regarding the behavior of absorbable suture. While the suture is designed to brake down on its own, only one suture really breaks down fast enough to theoretically avoid the need to remove the suture: 6-0 fast absorbing gut.  This suture has the potential to breakdown in about a week.  However, this seldom happens when used to close the upper eyelid incision for blepharoplasty.  For that reason, these sutures must be removed at about 5 to 7 days after surgery, a bit longer if a laser was used to make the eyelid incision.  I have encountered many, many surgeons who really to not understand the behavior of these absorbable suture.  They do not understand that more often than not, the suture used on the skin, simply does not break down fast enough and this leads to unsatisfactory suture marks.  Some surgeons are obstinate about this.  This is simple ignorance.  You are very early from surgery.  Things should soften and get better.

Curtis Wong, MD · Answer

can lead to scarring and milia... so if you have tracks from the sutures or whiteheads all over the lid, your surgeon should be held accountable for leaving in the sutures that long.  My patients have sutures removed in 3-4 days.  Unfortunately, some surgeons do not enjoy seeing their patients in follow-up and use the dissolving sutures so they don't have to be removed by the surgeon... I never understood why some surgeons prefer this over seeing their patients.

David Cheung, MBChB, Bsc(Hons), FRCOphth · Answer

Hi there. Greetings from the UK. Like your surgeon, I typically use dissolveable sutures for the skin crease incision. Although the manufacturers often quote typical durations for sutures to dissolve, it's not uncommon for them to remain a bit longer. Sometimes I do trim them at 2-3 weeks post op anyway for the convenience of the patient. I typically recommend to my patients though to apply some silicone gel to the wound though three times a day for patients at risk of scarring. In the UK we have Dermatix or Kelocote which is available without the need for a doctor's prescription. If you're genuinely concerned about hypertrophic scarring then let your surgeon know as they may recommend something similar. Best Wishes. David

Scarring, stitches in too long

Answers (3)