Permanent internal sutures - capsulorrhaphy

I am going to have capsulorrhaphy , and an implant exchange (downsizing) in a few months. I have read that permanent internal sutures are necessary. Does this mean they are not dissolvable? Thank you.

Doctor Answers 10

Permanent capsulorrhaphy sutures?

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.

Orange County Plastic Surgeon
4.6 out of 5 stars 21 reviews

Capsulorrhaphy does not require permanent sutures

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.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Capsulorrhaphy and suture type

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.

Lisa Cassileth, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 12 reviews


Capsulorraphy or sewing of your capsule in your pocket can be done to improve implant position and subsequently breast shape. I use permanent sutures as well for  this procedure; Please see examples below of patients who have undergone breast augmentation revision.

Arian Mowlavi, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 41 reviews

Permanent sutures does not necessarily mean permanent results

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.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 45 reviews

Permanent internal sutures - capsulorrhaphy

Yes, permanent means just that, they are there forever. That's the best way to go as the use of dissolving sutures often leads to failure of the operation. I have had to redo many capsulorrhaphies done elsewhere with temporary sutures. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews


I agree with your surgeon's plan to change to smaller implants and place sutures to elevate your implants and close off portions of their pockets.  I do not and have never used permanent sutures but do you slowly dissolving sutures that last for about 2-3 months.  Allow your surgeon to use the technique that he/she is most comfortable and successful with.  Regards,
Jon A Perlman MD FACS  Certified, American Board of Plastic Surgery  Extreme Makeover Surgeon ABC TV Best of Los Angeles Award 2015, 2016  Beverly Hills, Ca 

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

Down sizing

Thank you for the question and YES permanent sutures are used with a capsulorraphy though there are other newer techniques that can be used to accomplish the same thing without permanent sutures.  So discuss that with your surgeon or other expert in the field.
Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 58 reviews

Implant exchange and capsulorrhapy - are sutures permanent?

Thank you for asking about your implant exchange and capsulorrhaphy.
  • You are correct - permanent sutures do not dissolve.
  • I do not believe they are necessary for capsulorrhaphy but are an option.
  • I have used permanent and dissolving sutures for capsulorrhapy with good results with both.
  • Since every situation is different, rely on your surgeon's recommendations for you.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Permanent internal sutures - capsulorrhaphy

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.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.