Permanent internal sutures - capsulorrhaphy

With a capsulorrhaphy, it is not the sutures but the material being sutured that produces the long term result. The material being sutured is the scar capsule, which can be thin and weak or thick and strong. Once the healing has occurred, it is the tissue not the sutures that forms the new capsule dimensions. I have seen many failed capsulorrhaphies with permanent sutures. If the capsule is thin and weak it should be reinforced with an internal bra material such as Strattice, SERI, or Galaflex. If the capsule tissue is thick and strong, a slow dissolving suture works just as well as a permanent one.

Permanent sutures are generally preferred for capsulorrhaphy procedures since permanent support of the implant is desirable. However,if supporting mesh material is used,absorbable sutures are also used.

and you should be able to ask your surgeon to use the slowly dissolving sutures like PDS or Vicryl that will allow for adequate time for your pocket to heal.  In my practice, a cut out underwire bra is required for 6-8 months (including when showering) to help minimize the pressure on the incision line.  And even then, the procedure can fail where a revision may be needed so know what your surgeon's policy is before surgery.

Capsulorrhaphy is closing down the pocket in select locations to move the implant. I have best results with actually removing or heavily cauterizing the area to be closed down, then oversewing it with a long acting, absorbable suture that keeps the area closed off until the pocket heals on its own (like 2-0 PDS). I'm not a fan of permanent, since I do a lot of revision breast surgery and I'm pulling out other surgeon's prolenes, ethibonds, nylons, and other sutures which failed in the first place. Keep in mind if you have a really weak natural capsule, especially with a big implant that goes out and down, and strong pecs, capsulorrhaphy may not be enough.

Thank you for the question. Yes, permanent sutures are not dissolvable.  You may find the attached link, dedicated to this type of revisionary breast surgery helpful to you as you learn more.   Best wishes for a successful outcome.