Sutures (mostly the
dissolvable ones) will work themselves to the surface of the incision. This
happens quite commonly, and actually when a stitch does pop out, it can come to
the surface with an inflamed red spot. Usually you can feel something like
‘fishing line’ around this area. It is best to call the plastic
any suture makes it way to the surface for removal. You really do not want to
attempt to do this yourself, as this is way that
infections can start, and you
have to make sure you are removing a suture that is not something that is
permanent. Dissolvable sutures are usually clear color (like fishing line), and
permanent sutures are dark blue in color.
There are various types of
suture material that is used in closing an incision. Some
patients do have problems with sutures, and some sutures are more likely to
cause this than others. Braided sutures (such as Vicryl) can cause this and,
for that reason, many surgeons have switched to monofilament (unbraided)
sutures, such as Monocryl or
Vicryl is an excellent and strong suture
material, but it has been associated with "spitting”
Catgut: This suture
material is made from bovine intestine. Although catgut is the oldest
technology with dissolvable sutures, it can tend to create an inflammatory
reaction which can lead to an infection. Catgut loses strength quickly
- and has little use in modern surgery.
Vicryl / Dexon (Polyglactin-910):
Vicryl tends to dissolve slower than catgut - however, it has less of chance
of an inflammatory response. This suture material is intended for use
below the surface of the skin.
Similar substance to Vicryl, but
absorbed in a shorter period (5 days). Recent development, worth asking your
The least reactive suture material of this group, and
should leave least amount of scarring. Unfortunately this is not a very soft material
and may be slightly irritating while the stitches are in place.
- are a natural protein with 80 - 100 tensile strength lost by 6 months.
Silk is absorbed slowly over one to two years. Moderate to high tissue
- long staple flax fibers - 50 tensile strength lost by 6 months with 30 tensil
strength remains at 2 years. Non-absorbed sutures with moderate tissue reaction.
- polyamid polymer material with 15 - 20% tensile strength lost at a year.
Nonabsorbed with low tissue reaction - no contraindications.
Chromic catgut sutures
- made from collagen which is derived from healthy sheep or cattle tanned with
chromium. Tensile strength lost by 21 - 28 days. Absorbable sutures
with moderate tissue reaction. Not advised for tissue with slow healing
which will need prolonged support.
- polymer of polyglycolic acid. 80% tensile
strength lost by 3 weeks. Absorbed completely by 60 - 90 days.
Minimal tissue reaction. Not advised for tissues with slow healing which
needs prolonged support.
Polyglycolic Dermal Suture (PDS)
- absorbable polyglycolic dermal suture (PDS) is best in areas in which long
term tension strength is required. 85% tensile strength lost by 8 weeks.
Absorbed completely at 180 days. Mild tissue reaction - not advised for
tissue with slow healing that needs prolonged support.
Patient with Dissolvable
Sutures working their way through the incision line.
The area has inflammation and redness.
Patient had a Full Modified Anchor Lift and Breast Augmentation
It is very important that
if you see any discharge around this area, if the area feels inflamed or is hot
to the touch. Please call your Plastic Surgeon immediately, as this could mean
that you have an infection started, and you will need to start on antibiotics