Otoplasty - permanent sutures broke through the skin

Question

Hello, two years ago i had an otoplasty on both ears with permanent sutures. Two months ago i noticed that behind each ear i have one stitch coming out. I am going back to the surgeon who had performed the operation but prior to that i wanted to ask for any advice as to what i should tell him or what i should ask etc. This is the second time it's happened (the first time the stitch was out in only one ear) and i don't know if it is somehow his fault or if it is just 'nature'?

Waldemar Merck, MD · Answer

Before I answer your question, may I ask which method you had your ears pinned with? Was it the traditional method, by which the ears are cut open, or was it the minimally invasive Dr Merck Stitch Method?

Jeffrey Swail, MD · Answer

This is not an infrequent complication of otoplasty with the permanent sutures that are used to maintain the correction. The treatment is to remove the suture when it becomes exposed and then observe. In many cases the scar tissue will maintain the position and nothing more will need to be done. If the ear starts to stick out again the surgery may need to be repeated. It’s possible your surgeon will choose to use a braided suture rather than a monofilament (a single thread that looks and feels like fishing line) as these can be a little less stiff and prone to irritating and poking through thin skin cover.

Aaron J. Mayberry, MD, FACS · Answer

It's really no one's fault in particular. The skin behind the ear is relatively thin and over time the tail of the knot can work its way through. This can be more likely over time if permanent vs. absorbable sutures are used. At two months out you should have enough scar tissue to maintain the correction. Hope this helps!

Dr. M

Dr. M

Alastair J. Platt, FRCS (plast) · Answer

Sorry to hear you are having some trouble with the permanent sutures.  Its a great technique to correct ears but occasionally the sutures do prickle through the skin.  Its normaly easy to fix under a local anaesthetic especially if a suture was used with a smooth surface.  Best wishes.

Adam Goodwin, MBBS, FRCS(Plast) · Answer

there are pros and cons to permanent sutures and here you describe one of the cons. After this length of time the stitch will have done its job and so should be easy to remove under local anaesthetic as a small revision. Your original plastic surgeon is exactly the tight person to ask. Hope that helps. Adam Goodwin

Otoplasty - permanent sutures broke through the skin

Answers (5)

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