Show I am often asked if I use dissolving sutures during my facelifts or eyelid surgeries (blepharoplasties). The answer is yes and no. I do use dissolving sutures on the inside but never on the outside portion of the skin and for good reason. In short, I do not use dissolving sutures on the outside portion of the skin because I place the highest emphasis on imperceptible to invisible scars, and using dissolvable sutures on the outside does not meet this requirement. To understand why a little bit of knowledge about dissolvable sutures is helpful. The term “dissolvable suture” is really incorrect. Sutures do not spontaneously dissolve; it’s true they do not. The body actually has to create an inflammatory process to “breakdown” or metabolize or hydrolyze the sutures. Some sutures are designed to create a rapid inflammatory process to quickly breakdown or “dissolve” the sutures whereas others are designed to take weeks to months. The sutures that take weeks to months to “dissolve” are commonly used on the inside or underneath the skin, and I commonly use this type and, of course, these sutures never need removing.  However, on the outside of the skin (where a scar can be visible) the inflammatory process that is required to “dissolve” a suture can cause unsightly scars. That is, the inflammatory process can cause injury to the pigment producing skin cells around the suture, thereby causing white marks or scars that run perpendicular to the scar, which are nearly impossible to correct. This may not happen in most patients but it can in some and it’s hard to predict, so I decided long ago it was not worth the risk for any of my patients. So knowing this risk why would anyone use dissolvable stitches? The reasons are many but often the surgeon may not have the staff or desire to take the time to remove the sutures, or the patient may be apprehensive about the intermittent, mild discomfort that removing some sutures may cause. However, in my experience, and given the choice, most patients opt for a suture that needs removing, and therein a better, imperceptible scar. Although there are other factors involved in creating imperceptible to invisible scars, the choice of suture is clearly one that should be considered during any facelift or eyelid surgery. Timothy R. Miller, M.D. Dissolvable stitches are better suited for wounds; you don't have to take them out. Cultura RM Exclusive/KaPe Schmid / Getty Images/Image Source For centuries, dentists and oral surgeons, plastic surgeons, obstetricians, urologists and even veterinarians have used stitches to close up gashes, cuts and surgical incisions. Now, many physicians are using some form of dissolvable stitches (also called absorbable sutures). The great thing about dissolvable stitches is that they can be used on internal or external wounds. Stitches, dissolvable or non-dissolvable, have three features:
Dissolvable stitches differ from non-absorbable stitches because they are:
To your body, stitches are a foreign substance, and the body is programmed to destroy foreign substances. Dissolvable stitches are made from natural materials, such as processed collagen (animal intestines), silk and hair, as well as some synthetic materials that the body can break down. This allows the body to dissolve the stitches over time. Usually, by the time the stitches are dissolved, the wound is completely healed. Occasionally, a stitch won't dissolve completely. This usually occurs when part of the stitch is left on the outside of the body. There, the body's fluids cannot dissolve and decompose the stitch, so it remains intact. A doctor can easily remove the remaining piece of stitch once the wound is closed. Here are some interesting links:
Originally Published: Apr 10, 2001 Dissolvable Stitches FAQHow long does it take for dissolvable stitches to dissolve?The time it takes for dissolvable stitches to disappear can vary. Most fall out or start to dissolve within one or two weeks. However, in certain cases, they disappear after several weeks or months. What color are dissolvable stitches?Usually, absorbable sutures are white or clear in color. They are usually buried by threading the suture under the skin edges and are only visible when threads come out of the wound’s ends. Do stitches hurt when they dissolve?Any staples or stitches placed on the outside must be removed within 14 days. It is common to feel pain at the incision site. However, as the wound decreases, pain will also reduce. What do infected dissolvable stitches look like?You will notice red streaks or redness around the area. Pain while moving the injured area or touching the stitches is also an indication of infection. Besides, there might be swelling around the stitches. Should you pull out dissolvable stitches?No, you should never remove them without consulting a doctor. Usually, there is no need to remove them as they disappear on their own after some time. Can dissolvable stitches take months to dissolve?The time it takes for dissolvable or absorbable stitches to disappear can vary. Most types should start to dissolve or fall out within a week or two, although it may be a few weeks before they disappear completely. Some may last for several months.
What happens if dissolvable stitches are left in too long?When stitches are left in for too long, it can result in marks on the skin and in some cases, result in scarring. Delay the removal of stitches can also make it more challenging to remove the stitches. In the event the stitches or staples come out earlier than expected, there is a possibility that wound may reopen.
What happens when your body rejects dissolvable stitches?In some cases an absorbable suture can be “spit out” if the body doesn't break it down. This happens when the stitch is gradually pushed out of the skin because the body is rejecting the material. Spitting sutures can feel like a sharp spot on the incision, and a small white thread may start emerging.
What color are dissolvable stitches?Generally absorbable sutures are clear or white in colour. They are often buried by threading the suture under the skin edges and are only visible as threads coming out of the ends of the wound. The suture end will need snipping flush with the skin at about 10 days.
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Is it possible for dissolvable stitches not to dissolve
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