For eyelid lift, is it better to have staples or sutures? What type of suture has less chance of causing hypertrophic scars?

Question

I tend to form hypertrophic scars so I am afraid of having this surgery, although I really need to have this procedure. Can this procedure be done under local as I am afraid of anesthesia.

David S. Felder, MD · Answer

I have never heard of anyone using staples for eyelid surgery and only fine sutures should be used. Hypertrophic scars would be extremely rare as upper eyelid skin is very thin and heals well.

Marc Pacifico, MD, FRCS(Plast) · Answer

Many thanks for posting your question. The eyelid skin is very skin and usually heals with almost imperceptible scars. Fine stitches are normally used, and these are removed within the week of surgery. Whilst not impossible, it is very rare to get hypertrophic or keloid scarring of the eyelid.I hope this reassures you

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. Transconjunctival blepharoplasty is preferred when possible because there is no suture in the skin and patients can often return to normal social and work activities within a few days. This procedure can only be done if there is good elasticity to the lower eyelid skin. I suggest that you move forward and consult with a board certified facial plastic surgeon.
Best wishes,

J. Kevin Duplechain, MD, FACS · Answer

Staples are not used for upper or lower eyelid surgery.  Typically a suture that is  not  reactive is  used in the upper lid and removed at 5-7 days.  In lower eyelid surgery, a combination of absorbable suture under the lashes may be used, but a permanent suture laterally to help support the tissue is preferred, also removed at approximately 7 days.  Within the scalp such as with a browlift, staples are often utilized and  these areas are not prone to keloid formation

Janet Woodyard, MD · Answer

Never, ever heard of anyone using staples for a blepharoplasty! Hypertrophic scarring of the lids is unusual. I would recommend closure with prolene with suture removal 5 days later and the use of silicone after.Best of luck.

Mehryar (Ray) Taban, MD, FACS · Answer

I don't know anyone who uses staples for eyelid surgery! Sutures are definitely the way to go. Hypertrophic scars on eyelids are extremely uncommon. In regards to anesthesia, yes local anesthesia is definitely possible. See an example of a patient in video attached.

Keshav Magge, MD · Answer

Thank you for your question.  Eyelid surgery doesn't use staples.  For the upper eyelids, I use a suture that comes out at one week, and it eyelid surgery heals very, very well.  Because the blood supply to the face is so strong, the scars tend to be imperceptible after they heal.  Upper eyelid surgery can be performed under local, and lower eyelid surgery can be performed under local and sedation.  Best to speak to a board certified plastic surgeon.  All the best,

Adam Tattelbaum, MD · Answer

Thanks for your question. Unfortunately, any scar of any sort always runs the risk of becoming hypertrophic (thick). Hypertrophic scars are genetically mediated and you can't change your genetics. The good news is that while it is possible to make a thick eyeld scar it is not likely. Eyelid skin is the thinnest in the body and usually heals quite well. While the risk of a bad scar is low, it is not zero, so you must decide what your own risk tolerance is.I am really not aware of of any surgeons using staples in the eyelids. Most plastic surgeons use minimal and minimally reactive sutures in the eyelids to minimize the impact of the scar. I tend to use proline in upper lids for example. It is a minimally reactive filament that slides out easily in a few days leaving no suture material at all.Upper lids are commonly done under local anesthesia, but often lower lids are easier to treat with a patient asleep. Your PS will have to give you guidance based upon what needs to be done in your situation.Best wishes.

Reza Momeni, MD, FACS · Answer

In my experience staples are NEVER used for eyelid lifts.  As in NEVER EVER.  Not ever.  Never.

Jessica Kulak, MD · Answer

Upper eyelid blepharoplasty or eyelid surgery is usually performed using fine sutures that are removed 5-7 days after the procedure.  The eyelid skin is very thin and tends to heal very well with minimal scarring when performed carefully.  While hypertrophic scarring is possible it is very rare in the eyelids, even in patients that have hypertrophic scarring on other areas of the body.  I often perform this procedure  in the office with just a local anesthesia. Patients tolerate this procedure very well awake  and are usually surprised at how easy the procedure and recovery are.

For eyelid lift, is it better to have staples or sutures? What type of suture has less chance of causing hypertrophic scars?

Answers (17)

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