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Stitches after Cosmetic Surgery

November 12th, 2013

Is it true that all stitches need to be removed after cosmetic surgery?

In the past,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 such as Indermil ®, which are FDA approved, the new technology makes removing stitches a thing of the past in my office. I find that by taking more time with incision closure during surgery, I can offer a better experience for my patients.

Image:  INDERMIL ®

Absorbable stitches are simply absorbed by the tissue and replace the need for suture removal. Surgical glue is similar to “Superglue” and is now being used to close small skin cuts, lacerations (tears in skin) and as tissue closure for 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 very stressful for most patients 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  DERMABOND ®  or  INDERMIL ®  forms a strong microbial shield to protect wounds while they heal. There is a suggestion that the glue actually reduces the risk of infection. It also yields a better overall scar. The surgical glue does away with the need for most of the bulky dressings of the past, making recovery easier for the patient to manage. The glue simply washes off in the shower within about two weeks.

I’ve never had anybody come to the office and ask about glue having replaced the use of traditional stitches.  Surprisingly, many of my patients are unaware of these new methods and are pleasantly surprised at not having to worry about removal. It appears that none of my patients have missed out on the stress of having stitches or staples taken out.

 

 

 

 

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Steps in Cosmetic Surgery: Closure

September 17th, 2012

13.8 million cosmetic plastic surgery procedures were performed in the United States in 2011, according to the American Society of Plastic Surgeons (ASPS).  There are four universal steps to follow for all cosmetic procedure involving surgery.   As I have previously discussed so far, step one is incision, followed by dissection and sculpting.   This brings us to discussion of the final step, which is wound closure.

In elective cosmetic surgery cases, taking extra time to do an aesthetic closure is possible.  The first phase in wound closure is suturing (sewing) the skin and deeper tissues back together, also known as tissue approximation.   How well this is done will determine the physical appearance of the scar.  

 

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