What Do I Do with Protruding Permenent Stitch After Otoplasty

Question

I had otoplasty 1 year ago. Have a slightly protruding stitch and not sure what to do with it given that it's permenent stitching. Can the end be snipped off close to the skin in hope the end will recess eventually or do I leave it alone since only gets tender periodically.

Richard J. Bruneteau, MD · Answer

Occasionally permanent sutures will
erode through the skin following otoplasty.  When this situation arises the sutures can be easily removed
without anesthesia.  This can be
accomplished easily without pain in most cases.

At this point in the post-operative
course the ear shape is stable and shouldn’t be impacted by suture
removal.  It’s important that you
contact your surgeon.  Your surgeon
should be able to help you with this problem.

Andrew Miller, MD · Answer

Unfortunately, sometimes a suture can come through the skin. It is a natural reaction of the body sometimes and it is nothing to be worried about. All you have to do is make an appointment with your surgeon and it can easily be removed. Your ears should remain in good position because it has been a year since surgery and they are now fixed in good position. He then will also be able to tell you if there are any further problems developing. I wouldn't recommend waiting any longer because the suture can cause additional irritation which could lead to infection.

Nima Shemirani, MD · Answer

Dear Stevie m,

	A suture that sticks out can occur with the use of permanent and longer lasting sutures.  It is easily removed in the office, just see your plastic surgeon, and he/she should be happy to take care of you.

	Best,

	Nima Shemirani

Thomas A. Lamperti, MD · Answer

If the suture is coming through the skin, it should be trimmed by your surgeon. Often just shortening the knot is sufficient.

	If you can just feel the knot, you'd want to discuss your options with your surgeon. By a year from surgery the permanent sutures aren't typically as necessary to maintain your ear shape. Usually, the scar tissue that forms will maintain the ear position. Your surgeon will have a better idea of what role the suture you're noticing has in your otoplasty result and how to treat it.

Otto Joseph Placik, MD · Answer

A stitch that protrudes through the skin and can be easily identified at one year should probably be removed. However, if it is simply a prominent stitch that is palpable and not necessarily visible or exposed, I would probably leave alone.

Roger Woods, MD · Answer

Ear pinning back surgery (otoplasty) can be performed with the placement of permanent sutures to adjust the shape of the ear.  Specialist techniques can reduce the risk of these sutures ever protruding, but it can occur occasionally.

	See your surgeon -removal of the problem suture is simple and will not affect the long term result of your surgery.

Gordon Lewis, MD · Answer

Fortunately, this is not an uncommon problem, and has an easy solution. You need to return to your surgeon. He will likely pull on the stitch and remove the visible portion. If there is any evidence of infection, he may want to remove the whole stitch.

Samer W. Cabbabe, MD · Answer

I would recommend going to see your plastic surgeon to have this removed.  This can be a nidus for infection and a nuisance

Joseph Campanelli, MD · Answer

The foreign body nature of the stitch acts as a portal for bacteria to enter the skin and tends to lead to irritation and infection. It should be removed but have your surgeon do this as it is possible for your ear to change shape if done improperly.

Peter A. Aldea, MD · Answer

Regarding: "What Do I Do with Protruding Permenent Stitch After Otoplasty
	I had otoplasty 1 year ago. Have a slightly protruding stitch and not sure what to do with it given that it's permenent stitching. Can the end be snipped off close to the skin in hope the end will recess eventually or do I leave it alone since only gets tender periodically."

	Ear Pinning - Correction of Prominent Ears (Otoplasty) is done by a combination of techniques, depending on which features the individual patient's ears manifest. Oftentimes, the ear cartilage is folded back and kept this way with several permanent stitches which are then braced by the scar tissue that forms after the surgery.

	If a permanent suture comes out of the skin / becomes exposed, it by definition becomes in contact with bacteria which then colonize the suture AND make it impossible for the skin to heal over - converting the area to a permanent wound. Worse yet, the bacteria can progress along the stitch to the cartilage and cause a cartilage infection (Chondritis) which could deform the ear and may be hard to cure without removing the diseased cartilage.

	The stitch has to be removed in its entirety. You should see your surgeon and have him do it.

	Good Luck.

	Dr. Peter Aldea

What Do I Do with Protruding Permenent Stitch After Otoplasty

Answers (11)

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