How will my suture hypersensitivity impact my ability to heal from a facelift? (Photo)

Question

I learned that I have suture hypersensitivity from a brow lift and subsequent scar revision. In both cases, I had prolonged inflammation and hair loss from the sutures. The sutures for the brow lift and the sutures for the scar revision were made of different materials. I am 48 years old and would like to have a facelift in the next 2-5 years. How will my suture hypersensitivity impact my ability to heal? Thank you.

Alejandro Nogueira, MD · Answer

There was over tension at the closure site due to poor technical choice / planning, hence the baldness, the hair follicles die to to ischemia (poor blood flow) caused by the mechanical strain at the closure site.

You have hypersensitivity to poor quality work, just it. As old as the Universe: any suturing under tension at the scalp will lead to a patch of baldness and wide scarring.

Stephen Prendiville, MD · Answer

I am sorry that you had such problems after a brow-lift.  Healing in the temporal area from a brow-lift is usually imperceptible.  However, I use staples to close brow-lift incisions which tends to preserve hair follicles.  Perhaps excessive cautery and/or tension were utilized in your procedure?  This will also lead to hair loss. It is probably best if you obtain the operative note and information on the type of suture used for your procedure.  The majority of the sutures used in my deep plane facelift technique are PDS, PolyPropylene, or Nylon, which are known to cause very little skin sensitivity.

Zoran Potparic, MD · Answer

This is an issue you should discuss with your surgeon ahead of time in particular of you know what kind of suture you had reaction to. Properly selected sutures would help to avoid experience you had with brow lift. Good luck.

Ronald J. Edelson, MD · Answer

What happened in your scalp was likely from the tension from the incision closure. I would not expect you to have the same issue with a properly done facelift. It’s not an indication that your are somehow overly sensitive to the sutures

Muhsin Yilmaz, MD · Answer

Suture hypersensitivity can be challenging, but it doesn’t automatically disqualify you from having a facelift.
Here’s what’s important: • Material matters: Since you’ve reacted to different types of sutures, your surgeon will need a detailed history to avoid triggering materials. There are both absorbable and non-absorbable options, and even specialized “inert” sutures used in sensitive patients. • Custom approach: A plastic surgeon can tailor the technique &mdash; including using fewer or different suture types, adjusting placement, or opting for staples in non-tension areas. • Healing: Hypersensitivity can lead to prolonged redness, swelling, or hair thinning around incisions, so your healing may need closer monitoring and possibly slower absorbable sutures or alternative closure methods.
In short: Yes, you can have a facelift &mdash; but your hypersensitivity must be factored into the surgical plan from the start. Be sure to bring full documentation from your past procedures to any consult.

Mats Hagstrom, MD (license on probation) · Answer

How people heal after surgery is fairly unique and can very significantly from person to person.
Suggest you have a few in person consultations at which point you can discuss these topics further.
You can’t have a facelift without having sutures.
You’re going to have to put up with your reaction to the sutures and the healing process if you want more surgery.
Best,
Mats Hagstrom MD

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