MORE MONDAY MYTHS: Stitches ALWAYS Need to be Removed
August 2nd, 2010
Is it true that all stitches need to be removed?
For years, skin sutures (stitches) or skin staple closures needed to be removed after cosmetic surgery. Some surgeons still use removable skin sutures or skin staples to shorten the duration of surgery by quickly closing incisions using these older techniques. With the advent of modern absorbable stitches and surgical skin glue, which are FDA approved, the combination makes removing stitches a thing of the past in my office.
Absorbable stitches are simply absorbed by the tissue. Surgical glue is similar to “Superglue” and is now being used to close small skin cuts, lacerations (tears in skin) and surgical incisions.
How does surgical glue work? It is applied by an applicator to the skin. Once it comes into contact with the skin, the glue hardens rapidly and holds the edges of skin together so the skin can heal.
I prefer to use surgical glue and absorbable stitches for several reasons. I have found that patients really dread the removal of any skin closure device. It is just stressful to remain still while someone picks at a tender incision to remove sutures or staples. I also believe that surgical glue most often provides the least visible scare after healing. And finally, skin glue seals the incision. The adhesive material in specialty surgical glue forms a strong microbial shield to protect wounds while they heal. Some believe this actually reduces the risk of infection and yields a better overall scar, as well. The surgical glue also does away with the need for most of the bulky dressings of the past, making recovery easier for the patient to manage. The glue just washes off in the shower within about two weeks.
Surprisingly, many of my patients are unaware of these new methods and I’ve never had anybody come to the office and ask about glue having replaced stitches. However, certainly no one has missed out on the stress of having stitches or staples taken out.
Lipo as weight loss? Part 3
June 16th, 2010
Earlier in my career, I had the unique opportunity to be interviewed on television by Roseanne Barr and Tom Arnold about liposuction, which I discussed earlier this week. This series continues.
Lipo as weight loss? Part 3
Why isn’t Lipo a quick fix? I have found that cosmetic surgery results are far better when the fat layer located beneath the skin is as thin as possible before surgery. In the case of skin tightening procedures, the skin can be stretched more easily to give a better result. I also believe that wound healing is more efficient, there are fewer complications and patients see the best results when they are at a healthy weight.
Patients presenting for cosmetic surgery consultation who are carrying extra pounds frequently change their minds regarding which procedures they are pursuing after reaching their ideal weight. This is most evident with breast surgery. A woman considering breast reduction before weight loss will frequently choose breast enlargement after significant weight loss. Patients considering liposuction after weight loss usually only need a slight reduction of stubborn remaining localized fat pockets, such as the outer thighs. Skin appearance often responds better when weight loss is gradual and exercise is part of the program.
I know the idea of having surgery first, followed by weight loss and conditioning has been popularized on reality TV. It has never made sense to me. Why take this shortcut if there are increased risks, potential medical problems and compromised cosmetic results? Please consider being within 20 pounds of your ideal weight before considering cosmetic surgery. It is the best advice that I can offer my patients.
Remember: A moment on the lips, perhaps a lifetime on the hips!
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