Double eyelid surgery --feels like stitch is still present. Are stitches used internally, and do they remain indefinitely?

There are internal sutures to establish the fold in double eyelid surgery.  These sutures can form a bump that can be painful and visible.  Your body is reacting to the presence of the suture and causing inflammation which can manifest as swelling, redness and pain.At two months, it is likely that scar tissue has formed that will maintain the fold that was created.  The suture could be removed, and in most cases, the fold will stay.  In some cases it will not and the surgery will need to be repeated.  In my practice, I would start you on a course of antibiotics for a month to see if the bump and pain resolved.  If this did not resolve the issue, we would consider removing the suture.  Please see your surgeon who can best advise you regarding this.

This could be an internal stitch or scar tissue that is still hard. Either way you should have it seen by your surgeon.

Internal sutures are commonly used in plastic surgical closures, even sometimes in eyelids. If you have external lower lid incision you might have some inside sutures laterally. The pain you feel is more likely from a sensitive nerve that is "waking up". Gentile massage usually helps that pain over time. Show this to your surgeon for more exact information.

In double eyelid surgery, internal stitches are placed to create the crease. These stitches area permanent. Usually they are very fine but occasionally you can palate them through the skin.

Dear Eyelid123,

Following upper eyelid surgery,
different operative blepharoplasty physicians suture in different ways. Some physicians use a dissolving suture and
others use a nylon-type sutures. Nylon
sutures do need to be removed; however, it is not uncommon for small amounts of
the nylon suture not to be visible through the crusting in the early phase and
this can get trapped under the skin. As
you feel a sharp, stabbing-type sensation, it is quite possible there could be
a residual nylon suture. The absorbable sutures generally at eight weeks do not
give that sharp feeling and a thickening can be from scar tissue, although
sharp pain is uncommon.

In order to be certain, the best
advice at this early phase is to seek the expertise of your operative physician
to ensure there has been no suture material left behind. Occasionally under local anaesthesia, it is necessary
to make a small incisional defect in the area of the sharp pain to dig out
residual nylon sutures that will not go away.

I hope this information has been of
some assistance and best of luck.

Sincerely,

R. Stephen Mulholland, MD

Certified Plastic Surgeon

Yorkville, Toronto