3 Month Post Blepharoplasty and Suture is Coming out of Upper Left Eye! I Am Concerned.

Question

Other eye healed beautifully. But this one's scar line is still quite red. Part of suture became visible and was removed last week after I insisted the eye be looked at. Doctor had been dismissing redness until then in spite of radical difference in healing between the two eyes. Now more suture is emerging. Seems to be there in pieces. I'm terribly upset as I have never had any kind of complication. What to do? --58 yr old female in good shape

	Update: I went back to my surgeon, and it was indeed, a monocryl suture that was coming out of the upper eyelid. In my case, the body was not dissolving the suture very well on this one side. He made a small incision and removed as much of it as he could. It was fragmented and coming out in several areas. What is left is a small bit and should not present a problem. Thank you all for your feedback. The lesson learned is that while one can make a general rule about surgery, every patient is different. Why this one eye was a problem and the other not is a mystery!

Jed H. Horowitz, MD, FACS · Answer

if the skin is still red and suture material coming out there are a few options:

	
		wait and watch
	
		remove all of the scar under local and 
	
		revise with removable sutures
	
		revise with skin only dissolvable sutures

Kenneth D. Steinsapir, MD · Answer

However, the story is a bit unlikely.  Many surgeons use absorbable suture to close their blepharoplasty incisions.  Even if they missed a bit of this type of suture, it would all disappear before 3 months.  Surgeons also use very non reactive non absorbable suture.  Even if bits of this suture gets left behind, which is possible, but again very unlikely.   So it is possible to have a situation as you describe.  Seeing your surgeon is always the right thing to do.

	I am reminded of a patient with an unusual condition called a monofocal psychosis.  She was referred to me by her ophthalmologist because she was convinced that suture was coming out of her eyelid surgery.  She actually came in to the office with a match box containing what she described as suture material.  The eye was irritated and scabbed along the track where the eyelid had been closed at the time of eyelid surgery about a year before.  A pathologist examined the material in the matchbox but did not find suture material.  Instead the material was consistent with organized fibrin the material that forms a scab.  I suspected that she suffered from Ekborn's syndrome or delusional parasitosis and was actually scratching the skin can causing the skin breakdown.  Interestingly these people are often fine in all other respects, which is why this is sometimes called a monofocal psychosis.  She was successfully treated with a medication called Orap and the eyelid heal within weeks of her starting this medication.

	I am not suggesting that this is your situation.  I am suggesting that it is unusual to have retained suture in blepharoplasty and sometimes the problem can be something else.

Lawrence Bass, MD · Answer

While it is frustrating to have differences between the two sides during healing this is quite common (universally seen to at least some minor degree).  In the end, things will usually catch up and match well.  Absorbable sutures often surface and "spit" through the incision weeks or months later.  This may or may not be the cause of the redness.  It may be from the suture or whatever is creating inflammation may also be causing the suture to spit.  The important thing is for your surgeon to maintain surveillance and intervene as needed to help get the best healing.  Watchful waiting is usually what's called for but someone medically qualified needs to be watching.

William B. Rosenblatt, MD · Answer

Go see the plastic surgeon who did your operation. I assume you paid them, so go get the care you paid for.

Francis R. Palmer, III, MD (retired) · Answer

I'm not sure you need to be too concerned.  From what you describe it's most likely part of a permanent suture that should be easily removed by the plastic and cosmetic surgeon that did your Eyelid Surgery.

3 Month Post Blepharoplasty and Suture is Coming out of Upper Left Eye! I Am Concerned.

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3 Month Post Blepharoplasty and Suture is Coming out of Upper Left Eye! I Am Concerned.

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Answer: 3 Month Post Blepharoplasty and Suture is Coming out of Upper Left Eye! I Am Concerned.

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