Is it possible to have a deep plane facelift (or any type of facelift) with regular stitches rather than dissolvable stitches?

Question

Hello. Is it possible to have a deep plane facelift, or any type of facelift, with regular stitches rather than dissolvable ones? I’ve had dissolvable stitches twice previously for other surgeries and they never dissolved.I’m concerned to have dissolvable stitches again especially in my face. Can anyone advise on this please and if you’ve ever experienced stitches not dissolving and becoming embedded in the skin and the outcome please. Thank you

Ronald J. Edelson, MD · Answer

I don’t use dissolving stitches in facelifts although there is nothing wrong with it. Many surgeons use removable sutures but you can discuss this with your surgeon

Alan Gonzalez, MD, FACS · Answer

Hello @ls2304, thank you for your question. Yes, the choice of which type of sutures to use generally depends on surgical technique of the surgeon performing the procedure. Both types have their place in facial surgery, depending on specific goals or desired results. In general, most surgeons prefer long-acting absorbable sutures as they don’t require additional follow up visits for removal. However, regular non-absorbable sutures can be used in certain areas for added support and strength. Is important to talk to your surgeon and create a surgical plan according to your needs and what he can do in your case. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS),International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Stephen Prendiville, MD · Answer

Choice of suture will. depend on the individual Surgeon.  I typically use a combination of Prolene and nylon (permanent monofilament suture) and monocryl (absorbable monofilament) for skin closure, but there is no reason the suture lie can't be closed entirely with prolene and/or nylon.  These sutures are very nonreactive and allow for very little visibility of the suture line, in the right hands.  I use a long acting absorbable monofilament suture (PDS) for the SMAS layer, which dissolves in 3-4 months.  Permanent suture can be used for this purpose, but is less desirable for a variety of reasons.

Lexie Wang, MD · Answer

You would definitely need SOME kind of suture to help support and sustain the lift. It will either be dissolvable or not. It sounds like you don't want the permanent sutures, so your only other option is the disssolvable ones. Maybe you can ask if they can use a faster dissolving suture.

Arturo Valdez, MD · Answer

A facelift can be performed with different types of stitches. It all depends on the surgeon and his choice of sutures and what he is more comfortable using. For a Deep plane especially, we can not use dissolvable stitches because of the amount of traction needed to secure  the deep tissues and attachments of the face] must be permanent. I usually use materials such as Prolene or Nylon sutures.  I feel Prolene sutures are one of the best options.  With the remaining incisions where I close the skin, I try not to use dissolvable stitches in areas of the face that have a lot of curvatures. I try to keep the contour  around the ears and the area in front of the earlobe. Behind the ear is where I use absorbable sutures because there is no necessity to remove them .You have a previous experience with absorbable stitches, you need to know if those dissolvable sutures are designed for plastic surgery or for general surgery. Dissolvable Sutures used in plastic surgery are a high-quality material especially designed for that purpose with no adverse effects.

Jacob Tower, MD · Answer

Hello, hope you are well. Different types are suture material can be used in facelift surgery. For example I use a combination of absorbable ('dissolvable') and non-absorbable for various reasons. Most surgeons will have their normal preference, but if you were to ask me to use only non-absorbable sutures it would be no problem at all. That's an easy request to accommodate. You should know, contrary to your experience, it is actually a higher risk for non-absorbable sutures to become retained ('embedded in the skin') and cause problems. 
Best,Dr. Tower