Sutures for Lower Facelift and Neck Lift

The term "rolling" suture is probably a reference to a running suture as opposed to an individual or interrupted suture.  In general, the Facelift incision is closed with a series of interrupted and running sutures, employing 5-0 or 6-0 suture material.  With the technique I employ, the suture line is broken up into several components:  the first along the temporal hairline, the second at the junction of the ear (anterior helical crus) to the cheek, the third behind the tragus, the fourth in the perilobular portion of the ear, and so on.  A single running suture can lead to distortion of the natural anatomic components of the ear and is not advised.

While the use of meticulous techniques, fine sutures, and reduced wound tension certainly help in reducing facelift scarring, there are other factors that are important in terms of how a patient scars after a faceclift. Here is what I believe is important to reduce scarring:

 

1. The attention a physician's team pays to wrapping the skin after a facelift can impact scarring. In my opinion, some wrapping techniques place too much pressure on the skin, and such pressure can cause more tissue injury and impact the scars especially in front of the ear.  To this end, it is not only important that you get wrapped correctly after the lift to minimize the pressure, but also that your health care team teaches you and your family good wrapping techniques for your home care.

 

2, Proper wound care on the incison is very important for later scarring results. Patients who are taught to clean the wound well and apply proper wound care medications often get the best scars. Patients who neglect the wound and do nothing in the first 5-7 days can get sub-optimal scarring.

 

3, The use of scar creams is very important to getting an optimal scar line. Physician experience with these products and the proper use of them can be critical for optimal scarring.

 

4. Scar clinic resources are finally important when and if the scar is not optimal. Physicians with access to technologies like lasers can often quickly treat scars, whereas less optimally supplied clinics may not give you access to these technologies. Make sure you ask the physician what resources are immediately available to him or her should your scarring not be optimal.

 

Good luck! Hope this helps.

Short answer - the surgeon is most important, the technique second and third the suture material a distant third. Having practiced the art o plastic surgery for more than two decades (OK almost three) I have had the opportunity to watch surgical greats work during my training and as a professor of plastic surgery as well as critically examine my own results using different sutures, and techniques. The bottom line is that "great surgeons get great results" . For example using a permanent vs a rapid resorption suture (opposite ends of the spectrum) has not made a difference in my patients other than they no longer have to go through the hassle of  suture removal.