Severe Allergy to Permanent Sutures on Face, Etc?

In 2006, I had a facelift. 2008, I started having MAJOR swelling, pain and migraines. My doctor didn't help then,won"t help now. I saw 7 doctors.They gave me meds for pain and lots of antibiotics. The pain is deep. Took suture sample to an allergist.Of all the "latent reaction allergens" tested, I am MOST allergic to sutures. NO ONE will help. Antibiotics clear the infection but it heals over the area. Eventually, it swells, gets bumps and hurts again. What do you suggest I do? Please help me! Thank you

Doctor Answers 3

Suture Reactions after Facelift

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   If antibiotics cause the reaction to become quiescent, then the problem is not an allergy to the suture that is causing your reaction.  The best thing to do at this point is to determine if the sutures used to suspend the SMAS in the facelift were permanent sutures.  If they were, the sutures need to be removed and cultures sent.  Cultures need to be sent for aerobes, anaerobes, fungus, and mycobacteria. These later reactions are usually caused by mycobacteria and can be treated.

VERY VERY LATE Stitch Abscesses??

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 It appears you have developed stitch abscesses VERY VERY LATE following your facelift. Cultures of these draining areas should be taken and sent for bacterial, myobacterium & fungus. Ideally, these sutures will drain or spit out. May I suggest you request a copy of your original surgeons operative report. Normally, such a report will indicate the type of suture utilized and the extent of placement. Then, take this report to a local member of the ASAPS. They should be able to assist you.  Best,

Gary Culbertson, MD, FACS

Gary R. Culbertson, MD
Columbia Plastic Surgeon

Reaction to sutures

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That must be a difficult problem for you.  I agree with what others here have said- the sutures should be removed if you are indeed reactive to them, but there are MANY different kinds of sutures and the type you allergist tested may or may not be similar to the ones used in your face.  Get the operative report to figure out exactly what was used.

If antibiotics are helping, then it is likely not a reaction but an infection.  I would get the opinion of an infectious disease specialist who may put you on some longer term or stronger antibiotics to try to completely eliminate the infection- your current course is improving the situation but not killing all of the bacteria.

If you do have permanent sutures per the operative report, and a specialist is unable to eliminate the infection, then the sutures will need to be removed.  If there are draining tracks, these should be excised down to the sutures.  Good luck and best wishes.

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