Is this normal for a spit stitch? 1 month post-op. (Photo)

Dear MMHP17,in case of a spitting stitch, it can take weeks for a wound to fully heal. You should keep your wound clean and covered. I would suggest you to check it with your plastic surgeon.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery 
Member, Am. Society of Plastic Surgery

Yes, absorbable internal sutures do spit out - some patients have this happen with many of their sutures and others have it with none. It partly depends on how deep the layer of sutures right under the skin are placed (which in turn partly depends on the thickness of your dermis - the layer of skin that regenerates the outer layer), surgeon technique, and other factors. Sometimes the stitches poke the undersurface of the scar and can be felt, other times they poke right through and can cause irritation. Usually removing the suture if it is extruding is the way to help it heal. If it is extruding but not removed, it may cause a foreign body irritation by being exposed to normal skin bacteria. The only real cause for concern in these situations is whether the pinhole left behind by the suture coming out creates a window for exposure of the implant to the outside world - sometimes the pinhole is just in the skin layer and there is ample soft tissue underneath. In other cases, especially with very large implants, there can be inadequate soft tissue in the lower pole of the breast and the pinhole can mean the implant is actually exposed to the air, which is never a good situation. This is pretty rare, though, and most likely not occurring, but your surgeon can tell by examining you in the office.

Thank you for reaching out and sharing a photo. Spitting stitches happen and do leave a "hole" where they pushed through. From the photo alone it looks ok, just be sure to keep in close contact with your surgeon and follow their instructions on how to care for it. Best of luck! Dr. Kachenmeister