Would you recommend staples or not for a Facelift?

Question

My impression is that most doctors use staples during a face lift. There is one doctor that I know of who does not. My impression is that staples leave more scarring. Also, using staples seems like a short cut to me. What do you all think about that?

Martin Jugenburg, MD · Answer

Staples look and sound scary, but when used properly, they not leave scaring that is any worse than sutures. In some cases the scar may even look better.  The key is that they are take out within 5 days.  Staples are usually used in the area behind the ear, not in front of the ear.

Vincent N. Zubowicz, MD · Answer

Because the resulting scar is a critical part of a facelift result the plastic surgeon will take special care to close the incisions. Staples are not part of that recipe.

Bryson G. Richards, MD · Answer

Thanks for your question.There is a small study that looked at staples versus sutures placed in hair-bearing skin. The outcome studied with postoperative hair loss. Staple use in the hair trended toward less alopecia (hair loss) compared to sutures. Regardless, I use sutures in the hair bearing skin because in my hands, I feel that I am lining up the tissue in a more aesthetic manner.Don't choose your surgeon based on staples or not. I'm sure if you made a personal request for staples, most surgeons would oblige.I hope this helps.- Dr. Bryson G. Richards, MD

Jonathan C. Weinrach, MD, FACS · Answer

There are probably as many different ways to close facelift incisions as there are facelift surgeons.  Staples are only used in incisions that are within hair - these areas are covered by hair and are not visible after the staples are removed.  Using staples in these areas rather than sutures is certainly faster, resulting in a shorter operating room time and less anesthesia - which probably equals more safety for the patient (and less cost).  So yes, you could say the use of staples is a "short-cut" in terms of operating room and anesthesia time, but certainly not in terms of quality of result, if they are used in hair-bearing areas only.

Parker A. Velargo, MD, FACS · Answer

Great question.  In my practice, the use of staples is limited to the hair bearing areas of closure.  Staples are fairly non-reactive and result in little surrounding inflammation with use.  It is also more practical and comfortable for the patient to have staples removed from the hair bearing areas as opposed to trying to cut sutures, which can often times be confused for hair.  Placement of staples is not a haphazard technique and should not be perceived as a "short cut".  It actually requires lots of practice to be able align the skin properly with staples.  In some areas, I actually use fill in absorbable sutures between the staples to help with alignment.  In the end, regardless if staples or sutures were used, the cosmetic result of the closure is dependent on two important things -- a tension free SKIN closure and proper alignment of the skin edges.  Seek the consultation of a facial plastic surgeon or plastic surgeon for
 a detailed discussion on his/ her technique and a peek at some before/ afters.  I wish you well!

Timothy R. Miller, MD · Answer

I do not use staples.Staples do save time especially when closing incisions in hair-bearing areas.  However, it is my opinion that a better, more "invisible" scar is produced with good suturing technique when compared to staples, although suturing does takes more time.The link below provides more information.I hope this helps.

John J. Martin, Jr., MD · Answer

Most surgeons will use staples to close any incisions within the hair bearing areas.  The staples do not leave a large scar.  And within the hair they are much easier to use.  When trying to use sutures within the hair, the hair gets in the way when trying to tie the knots.  It also is easier to get hair caught in the wound with the sutures.  So for many reasons staples are preferred there.  Once outside of the hair bearing areas, most people use sutures.

Salvatore Pacella, MD, MBA, FACS · Answer

In general, staples are used in areas where scars can be hidden.  For example, in a browlift within the hairline or in a facelift behind the ear, staples are common to use.  For all other VISIBLE areas, such as in facelift incisions in front of the ear, fine suturing is preferred.  I would ask just where the staples are to be used.  In general in my practice, I avoid ANY staple use in the face...regardless of the location.  I believe sutures provide better approximation and distribute tension better.  My creedo (again just my opinion):  staples and glue are for paper, sutures are for skin.

Michael I. Echavez, MD · Answer

Using staples or not during a facelift is determined by the preference of the surgeon.  I do not believe that staples cause more scarring than sutures and my preference is to use staples around the hair bearing incisions, and sutures around the skin of the ear.

Matthew Kaufman, MD · Answer

Thank you for the question.  It is normal for people to use both staples and suture to close facelift incisions or just suture alone.  There is no right or wrong method, it just depends on how it is done and where the staples are placed.  Staples are only used on incisions in skin with hair, such as behind the ear or in the sideburn area.  The use of staples is not considered a shortcut, just another means of achieving a pleasing aesthetic end.  Please discuss this during your consult with a board certified Plastic Surgeon.

Would you recommend staples or not for a Facelift?

Answers (20)

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