Which suture leaves more scarring: dissolvable or non dissolvable?

In my opinion dissolvable sutures produce the most scarring. The sutures dissolve by causing inflammation. This inflammation produces scarring.  

I prefer the non-dissolvable, because those sutures are removed within a week. That leaves NO FOREIGN OBJECT in your skin. The dissolvable kind "dissolve" by stimulating inflammation. That can result in a longer healing period. Ask for non-dissolvable. 

Long term - I think they are similar. However, in the short term a permanent monofilament suture like 6-0 Prolene creates the finest, most narrow and least inflamed facial scar. Sutures are usually removed between 5-7 days. For sutures placed under the skin, I usually prefer dissolving sutures as the inflammation created by their degradation isn't visible. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Both dissolvable and non dissolvable sutures can be used with equal success closing skin.  The nature of the suture used will dictate when the surgery should be removed.  A non dissolvable skin suture is generally removed within 5 to 7 days of placement.  This can depend on the precisely nature of where the suture is placed.  So for simplicity, lets talk about the upper eyelid.  Any suture will induce inflammation.  Generally, permanent sutures like nylon or prolene are less inflammatory than absorbable suture.  The key is picking the right suture for the job and removing suture at the appropriate time.  Fast absorbing sutures made from gut disappear in about 6 days when kept moist.  Still the surgeon should remove whatever has not broken down at the end of this time frame.  Similarly, to avoid suture reactions, permanent skin sutures need to be removed also at the end of 5 to 7 days to avoid incision cysts and suture inflammation.  Longer term absorbable suture material such as chromic cut and vicryl basically act like permanent suture for the first few weeks and do not break down until many weeks later.  For this reason, these "dissolvable" sutures also need to be removed at the end of the 5 to 7 day time frame to reduce the risk of tissue reaction to this material.

but permanent sutures must be removed by a certain time after surgery (as determined by your surgeon) to prevent the stitch scars like Frankenstein's.  Dissolveable sutures cause reactions as they dissolve but they lumps usually go away.  Bottom line, the scar quality is often a reflection of the meticulousness of how the wound was closed and not what suture was used in closing.

Hello Nikialex, This is a great question that has been debated and well researched. For clean wounds or incisions such as in an eyelid surgery there appears to be no long term cosmetic difference in healing. There can be a difference in terms of the immediate amount of inflammation from absorbable sutures giving a more red appearance to the wound edges as your body attempted to breakdown the suture.  The non-absorbable sutures are generally less reactive and less likely to cause any noticeable inflammation.The timing of suture removal is very important due to risk of developing cysts around the sites of the suture entering the skin at the level of the upper eyelid.As long as you are seeking a board certified qualified surgeon their choice of suture should be appropriate. Good luck. Dr. Shadfar

There are many types of suture, both dissolvable and nondissolvable. Each has its purpose. For external incisions, my preference is nondissolvable for meticulous closure. These induce less of an inflammatory process.

In my personal experience we have better scarring results with monofilament absorbable sutures than with permanent sutures, since we place the suture in a subdermal plane.Spanish Translation:En nuestra experiencia personal tenemos mejores resultados en la cicatriz de nuestro pacientes suturadas con suturas monofilamento que con suturas permanents las cuales se retiran al cabo de unos diez dias. Esta sutura la realizamos en un plano subdermico.

This has to do with where the suture is used and how long it is left in place. The dissolvable sutures have varying length of time at which they are expected to dissolve. For deep sutures on visceral tissue, we use dissolvable that take up to 120 days to disappear; whereas, on the skin (e.g. lower eyelids) we would used fast-absorbing that take 7-10 days to dissolve. The non-disolvable or non-absorbable or permanent sutures are used deep when we want a long-term hold using the suture's strength (e.g. SMAS face lift) or on the skin for 7-10 days after which they are removed. The non-dissolvable sutures are not as reactive as the dissolvable ones and cause less inflammation and scarring if they are removed promptly, but will cause significant scarring if left on the skin too long (foreign-body reaction). Similarly, if the wrong type of dissolvable sutures is used on the skin, it will cause significant scarring. Suture selection is complicated and has everything to do with the procedure and the tissue being sutures as well as the surgeon's experience and preference.

They both can leave very acceptable results, but there are many factors that can impact incision healing with dissolvable sutures.  Oilier skin types can develop suture tracts with dissolvable sutures, and with non if left in too long.  I generally use non-dissolving sutures as the inflammation from dissolving sutures can make the incisions more red and slower to become less conspicuous.  However if dissolvable are placed as interrupted sutures vs a running placement they tend to cause less inflammation and can allow wound fluid egress, which can speed resolution of swelling.  These are some of the issues that you can ask your surgeon about.