My incision line (areola) is really hard. It feels like there are sutures underneath, is this normal? When will it go away?

Question

My incision line (areola) is really hard. It feels like there are sutures underneath that are not dissolving. 5 weeks post op. Split a stitch (looks cotton) also.

Emily J. Kirby, MD · Answer

This is very normal during the early post-operative period.  What you are likely feeling is scar tissue, which is a normal part of the healing process.  You can assist the scar tissue in softening by performing scar massage using an oil-based cream.  Ask your plastic surgeon for recommendations.  I advise my patients to use Eucerin original crème, Bio-oil or Mederma.  Depending on what kind of sutures your surgeon placed, it may take weeks to months for them to completely dissolve.  During this time there is a reaction in the body that helps them to break apart as they are supposed to do.  This can sometimes cause a more firm feeling and more scar tissue as the process continues.Spitting stitches is common.  The sutures should be dissolveable, so you can leave it alone.  You should never pull a suture to remove it.  You will need to ask your surgeon if you can trim a spitting stitch or if it should be left alone.Congratulations on your surgery!

Bruce Landon, MD · Answer

This can be completely normal in the early post-operative period. The hardening can be from scar tissue which generally softens over time. Most surgeons use dissolvable sutures which may take several months to dissolve. Your plastic surgeon may be able to prescribe a topical cream to ease your post-op discomfort.

Kamakshi Zeidler, MD · Answer

Many patients experience small wound healing problems after surgery. Many plastic surgeons use absorbable sutures that your body breaks down over time causing the suture material to dissolve. Depending on the suture type that is used, this can take up to 3 months. In addition to this, your body goes through a healing phase after an incision is made. Collagen is placed to make the incision area stronger, and this creates a scar. After the first month or so, most of the strength of your tissues has been regained and the body begins to remodel the scar into a softer form of collagen. The combination of scar tissue formation and sutures being broken down can lead to an incision feeling hard. Time alone usually results in softening of the scar. Mechanical disruption of the scar with massage can help the collagen to soften more quickly. Silicone sheeting or gel can hydrate a scar to help transform the collagen into a softer form. You should discuss with your plastic surgeon which of these maneuvers might improve your scars.With regard to spitting sutures - you should have your surgeon evaluate the wound because a break in your skin may put you at risk for an infection. Sometimes the body has a difficult time breaking down and dissolving sutures and instead pushes them out through the skin - sometimes leading to an opening. This can be treated with removal of the suture and antibiotic ointment. Most surgeons will have you wait to do scar massage or silicone treatment until the incision has closed.

Brooke R. Seckel, MD, FACS (retired) · Answer

The hardness that you feel is likely dissolving sutures that have not dissolved.  In addition new scar tissue forms around these absorbable sutures and can create a feeling of firmness.  Please ask your plastic surgeon about the possibility of massage to soften the scars.   If you are spitting sutures you should also see your plastic surgeon.

My incision line (areola) is really hard. It feels like there are sutures underneath, is this normal? When will it go away?

Answers (4)

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