You are asking one of the Million Dollar Questions in Plastic Surgery.Personally, I use a combination of dissolvable sutures, permanent sutures (which need to be removed), and sometimes staples IF the scar is inside the hairline.The dissolvable sutures are used deep inside the cheek in order to hold the tissues where I want them to stay. They typically stay in place for about 3-4 months before being absorbed.I like to use permanent monofiliament sutures (like nylon or praline) in the skin to approximate the wound edges because your body is unlikely to react to them as long as they are removed by day 5 or so.Staples are occasionally useful within the hairline because they are a very fast way to close the scar that nobody is ever going to see anyway. Furthermore, I remove them at day 5 as well (when I take out the sutures) so there shouldn't be any visible "railroad track" marks from them. The reason time is important is that the Anesthesia is so expensive. If I can save the patient 20 minutes of OR time by using staples and nobody is going to know the difference two weeks later, then that equates to real dollars and cents.Okay, sorry for the long answer, but that's what I use and why I use them...Good Luck!