Do internal facelift sutures remain palpable forever? I can feel a small hard lump on cheek in front of each ear in same place.

One year post-op. Not sure what type of facelift I had, and surgeon doesn't seem willing to go into detail. I think it was some type of imbrication or quicklift procedure. It hasn't really worked and I still have jowls and other issues (eg loss of tragus and ear-lobe distortion). This question though is about palpable sutures. I can feel a small knot-like lump on each cheek just in front of each ear on the cheekbone. I presume these are permanent sutures. They feel horrible, can they be removed?

Doctor Answers 26

The "Quicklift" Facelift and permanent lumps one year post-op; QUICK and SURGERY should never be together

Thank you for your question. 

I am personally not a big fan of "quick-anything" as "quick" and "surgery" should never go together.  I do believe in efficiency and meticulous work.  Often, with "quick" techniques, one has to use bigger sutures to achieve any lift and perhaps those are the stitches you feel.  I do personally use a few permanent sutures in my comprehensive SMAS double layer facelift but they are small and buried. 

That being said, it is usually feasible to remove the old permanent sutures 3-6 months post op but it means reopening somewhere to access them.  I put mine close to the hairline/ears so if needed, they are easily accessible.  The ones over the cheek bones are dissolving in my practice and melt within 2 months or so.

Go back to your surgeon and express your genuine concerns.

Hope this helps!

Kind regards,

Dr Marc DuPere, Aesthetic Plastic Surgeon



Toronto Plastic Surgeon
4.8 out of 5 stars 60 reviews

One year after

If you still have a palpable knot one year after facelift surgery it is most likely that a permanent suture was used and somehow came close to the skin surface causing it to be palpable. This should be an easy fix and is likely easily be removed under local anesthesia in the office. 

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
4.9 out of 5 stars 48 reviews

Palpable sutures after a facelift

Thank you for your question. 

Both absorbable and non-absorbable internal sutures can be used during a facelift to elevate and secure facial soft tissue.  Most absorbable sutures would be expected to go away within 3-4 month after the procedure.  If one year after a facelift you still feel palpable knots, it is likely that permanent sutures were used.  If these knots bother you, they can be easily removed.  It would require a small procedure under local anesthesia to cut and remove the stich.  Removing the stiches at this point would not affect your results.  If possible, I would recommend asking your original surgeon to do this, since he is in the best position to know the location and the type of sutures that were used during your procedure.

Best wishes!

Dr. Konstantin

Konstantin Vasyukevich, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 36 reviews

Lumps could be permanent sutures

Without assessing you in person, hard to say, but if permanent sutures were used then yes, it is quite probable that the lumps are there to stay. I am so sorry that you are unhappy with your results. Perhaps you might want to get a second opinion from another board certified plastic surgeon in your area who can assess your face in person.

Kindly,

Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 21 reviews

Palpable sutures

If non-absorbable (permanent) sutures were used during your facelift it is likely that the lump you feel will not go away. The good news is that if the lump is caused by a surgical stitch it can be removed. Sometimes it is possible to use the same facelift scar to remove the lump when it is located close to the scar. 

Gabriele Miotto, MD
Atlanta Plastic Surgeon

Palpable internal sutures after facelift

You might want to just consider a revision.  I say this only because you mention a few other areas of dissatisfaction in addition to the palpable sutures.  Your surgeon should be willing to go into as much detail as needed for you to understand what was done at the time of the operation.

I prefer long-lasting but dissolvable sutures.  They typically resorb after a period of 3-4 months or so.  This avoids long term issues related to the use of permanent sutures.  Once there has been adequate time for the tissues to heal in their new lifted and supported position, the need for a suture to remain there forever does not make much sense to me.

David W. Rodwell III, MD
Charleston Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Palpable knot

Assuming that what you are feeling is a permanent suture, those can be removed in the office using local anesthetic. However, considering you have other issues associated with your prior facelift, you may want to consider a revision lift. During that revision, the permanent knots can be removed and your other issues (jowls, tragus, earlobes) can be addressed. See someone with extensive experience with revision facelifts.

Andrew Campbell, M.D.

Facial Rejuvenation Specialist

Quintessa Aesthetic Centers

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Yes

A simple procedure under local anesthesia can open up the incisions in front of the ear and dissect to the knot and remove it.  This may also help to revise the scars that have distorted your tragus and earlobe. 

Palpable sutures in face after face lift.

Some surgeons use permanent sutures and some use long lasting but dissolving sutures in their facelift procedure, usually to lift the deeper tissues and hold them in place during the healing.  The dissolving sutures may be palpable for several months but then will be gone.  The permanent sutures obviously will be there forever.  Removal of the bsutures can be done in the office with local anesthesia only.  The improvement of the jowls, correction of loss of the tragus and ear lobe distortion will require a revision of your facelift, but also could be done with local anesthesia.  If you don't want to return to your original surgeon, be sure to obtain your operative notes so whoever you choose will know what was done the first time.  Best wishes.

Palpable lumps after facelift procedure

The small lumps that you can feel would be consistent with sutures, although it would be ideal if your surgeon would provide the details of the procedure to you.  It is not unusual for surgeons to use sutures that do not absorb over time in these procedures, especially with the intention of trying to achieve long-term persistence of the results.  The more superficial those sutures and/or knots are situated, the more likely they will be palpable.  In most instances, these can be removed without much difficulty, generally under a local anesthetic.

Saul R. Berger, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.