Is it better to have stitches or dissolving stitches for upper blepharoplasty?

Question

Is it better to have stitches , as opposed to the dissolving ones? I heard that the dissolving stitches could cause more scarring . Is this true?

David S. Felder, MD · Answer

I have not used dissolving sutures for blepharoplasty and prefer to remove traditional sutures when the wound is sufficiently healed. Dissolving sutures do tend to create more inflammation and irritation.

David W. Rodwell III, MD · Answer

I prefer sutures that need to be removed, and for upper eyelid surgery I use 7-0 Ethilon (a nylon monofilament suture).Dissolvable sutures are fine.  I do think there may be more inflammation with them but likely not enough of a difference to be clinically significant.  The main issue is that eyelid sutures can and should be taken out early.  I usually remove sutures around day 5 or so but certainly within 1 week.  At that point the dissolvable sutures are starting to break down but still have pieces of them that need to be removed anyway.  There is no reason to leave them in longer.

Ritchie Younger, MD · Answer

Seek out a Board Certified Facial Plastic or Oculoplastic Surgeon, who has vast experience performing Blepharoplasty surgery, and you will find your answer.  17 years ago, my Facial Plastic Fellow performed a survey of Facial Plastic Surgeons in Canada and the USA, regarding type of suture used for all manners of Facial Plastic Surgical Procedures.  At that time we found that 45% of polled surgeons used dissolving sutures for their Blepharoplasty procedures, while 54% used sutures that would need to be removed. (1% alleged that they used glue of some type).  With this survey we find that indeed some surgeons prefer dissolving sutures and others don't, based on vast  and varying levels of experience.  More important than suture type is the judgement of the surgeon, so seek out an experienced surgeon with vast blepharoplasty experience, as this, rather than suture type, will generally lead to a better result.  Good luck to you in the quest for newer eyelids !!

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. Your surgeon should use the approach that is best. While the type of suture is important, you should make sure that you are working with a board certified facial plastic surgeon who has plenty of experience performing blepharoplasties. Your recovery will also be influenced by your ability to follow the healing instructions.
Best wishes,

Andrew Campbell, MD · Answer

Studies have shown that scars look better early on if the sutures are removed compared with dissolvable sutures. However, long term the scars looked the same. I personally use removable sutures just so the scars look as good as possible as quickly as possible.Andrew Campbell, M.D.Facial Rejuvenation Specialist
Quintessa Aesthetic Centers

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  I prefer to use a single running prolene suture which is not dissolvable.  It is a pull-through stitch which is removed 4-5 days after surgery.  I find this results in a great appearance.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  
 
 Best wishes and good luck.

Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon

Piotr Osuch, MD · Answer

Approach to stitching varies from surgeon to surgeon. You should discuss this with your dr directly. In my practice I stick to  traditional sutures for this type of surgery. We get them  removed around 7 days post-op. In this way we minimize risk of any irritation a patient may get from dissolvable stitches.   
best regards, 
Piotr Osuch

S. Randolph Waldman, MD · Answer

Different Physicians prefer different approaches. We utilize a very fine external suture with an extremely small needle i.e. 7'0. The real key is the size of the needle and the fact that using sutures gives you more control over the tissue reaction than using sutures that are not removed and must absorb over a period of day.Sincerely,S. Randolph Waldman, MD

Steven Wallach, MD · Answer

Either suture is fine. I usually use sutures that I have to remove to minimize any irritation one might get from dissolvable stitches.

Kristina Tansavatdi, MD · Answer

Whether a surgeon uses dissolvable or permanent sutures is determined by surgeon preference. The final outcome is not ultimately effected by the type of suture and rather by the designed incision and the meticulous technique for closure.

Is it better to have stitches or dissolving stitches for upper blepharoplasty?

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