Will Spitting Stitches Affect Breast Lift Scars?

Hard to make any clinical recommendations without photos or an exam. You are
going through an active healing process that will take months to
complete. Most plastic surgeons put
specific sutures in certain tissues for a reason. In a breast augmentation and mastopexy, most
usually close the tissue in layers to keep the tissue together and to
take tension off the wound. Deep layers are usually absorbable and the
skin sutures non absorbable that have to be taken out. Sometimes
sutures from the inside will spit out through the wound. If this is the
case you may have a little opening. This is usually OK, and will heal,
but should be seen by your plastic surgeon or whoever is covering for
him/her. I tell my patients... No kitchen surgery, come in and we will take
a look. The scars may be a bit wider where the sutures spit out of.  Please continue to inform your board certified plastic surgeon.

It’s not unusual for
absorbable sutures to work their way to the surface of the wound.When this happens, they frequently develop
localized infection around the suture.This is known as a stitch abscess and is easily treated with local wound
care.This requires removal of the
suture and dressing changes.In some
cases, antibiotics will be necessary as well.Unfortunately, when this happens early in the
postoperative course, scars can sometimes spread.Rarely correction requires scar revision at a
later date.It’s important that you
consult your plastic surgeon if this is occurring.Your surgeon should be able to develop a
treatment plan that addresses your concerns.

Hello! Thank you for your question.  It is certainly possible and proper wound care is warranted - discuss with your surgeon. It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit are silicone sheets, hydration, and topical steroids. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process. If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself. Hope that this helps! Best wishes for a wonderful result!

Unfortunately, despite best efforts, sutures can “spit” causing a minor complication along the incision lines. This issue is usually self limited and often resolves quickly after the stitch is removed. Nevertheless, the phenomenon does cause anxiety for the patient and potentially does lead to a wider scar in the area ( because of the increased superficial inflammation).  Occasionally, scar revision is necessary to improve the scar's  appearance.

Hope this helps.

 

Spitting stitches, the exposure of stitches is a common complication in Plastic Surgery. It is associated with braided sutures more than others but no suture brand is immune from this complication. Once the suture is exposed, bacteria cover it and as a colonized foreign body the wound will not heal over it unless the suture is removed. Unfortunately the spot where the suture popped out is wider than the rest of the scar and if several stitches were exposed and did so early in the healing process the scar will be wider. This can always be revised much later on (with a different suture and possibly closure technique).

Peter Aldea, MD

Yes due to the inflammatory response from the suture rejection. Try local care to allow healing. Than silicone sheeting. 

Sometimes a suture will spit and the hole will close up and the scar will be normal, and other times the inflammation will lead to a scar that is wider in that area.  If the scars become unsatisfactory as a result, your surgeon may be able to revise them and use a different suture material.  There is no way to predict in advance who the relatively few patients are that will "reject" any given commonly used suture material.

The splitting of stitches in a wound is not an infrequent occurrence. The wound usually heals with local wound care and without further surgery. If the resulting scar widens, a scar revsion can be planned after 6-12 months under local anesthesia. The important thing is not to have to worry and just follow the advice of your plastic surgeon.