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Stitches under skin

Dr. Naderi answers your questions about all facial plastic surgery procedures, from facelift, rhinoplasty (nose job), to eyelid surgery (blepharoplasty), and dermal fillers.

Stitches under skin

Postby dawngurl » Thu Nov 01, 2007 7:10 pm

I am having problems with the stitches my doctor made during a face lift a year ago. The stitches are ones he made under the skin to tighten the muscles on the sides of my face. I have about three or four bumps on both sides of my face in a direct line going done my face. I have had them ever since last year at this time. I went to my PS because I had one of the bumps to break the skin and get infected. He told me it was a stitch and he got it out and it did get well. I showed him other bumps on my face and he told me it was just the stitches under my skin where he tightened my muscles. About two weeks later I had another one to do this. I called his office and explained everything to her. How long it had been since my face lift. And the visit I had earlier and my PS removing the stitch. She told me I would have to remove it myself this time. That the Doctor wasn't going to do it again. I was shocked. I asked her how I was suppose to do that. She said I would have to wait for it to fester up and break the skin then I could use tweezer and get it out. I told her I couldn't see it because it was on the side of my face. She wouldn't give me an appointment. About six months later I still had the bump on my face which stayed infected. Every night I would squeeze the pus out ( this is what the girl at the PS told me to do. I finally got tired of it when I had about three more pop up. I called my PS and the office manager told me to come down. My PS gave me a huge prescription of tetracycline to take. What I am afraid of is a bad skin infection on my face. I keep having these horrible scenes in my head of a raging infection and a face like some kind of freak! Do I have reason to be worried. My PS said he thought my body was rejecting the material he used for the stitches. I am to call in three weeks if it isn't cleared up. Please help me. I don't know if I am doing the right thing or taking chances with my face. I only have one face. Thanks Dawn
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Postby dawngurl » Sat Nov 03, 2007 10:06 pm

Thanks for all the help. This is such a helpful site. :x
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Postby Dr_Naderi » Sun Nov 04, 2007 1:42 pm

She told me I would have to remove it myself this time. That the Doctor wasn't going to do it again. I was shocked. I asked her how I was suppose to do that. She said I would have to wait for it to fester up and break the skin then I could use tweezer and get it out. I told her I couldn't see it because it was on the side of my face. She wouldn't give me an appointment. About six months later I still had the bump on my face which stayed infected. Every night I would squeeze the pus out ( this is what the girl at the PS told me to do. I finally got tired of it when I had about three more pop up. I called my PS and the office manager told me to come down.



If indeed the office staff told you this and it was not a rogue office worker going out on her own and just telling you something without the approval of the surgeon or if there was no miscommunication then I find this surgeon and her office staff very distasteful and unethical. It is her sutures and she should be taking care of you - period!

The important thing is to know what kind of sutures these are. Are they permanent such as Prolene or Ethibond or absorbable such as Vicryl or PDS, etc...?

The antibiotics is not a bad idea but a surgeon needs to see you and come up with a plan whether its your own surgeon or another one.

You don't need to panic but you do need to see a surgeon very soon to be evaluated.

Keep me posted.
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

www.RhinoplastySpecialistSurgeon.com


[Online replies to questions are NOT a substitute for actual consultation & exam & should not be considered "medical advice."]
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Stitches

Postby dawngurl » Sat Nov 17, 2007 6:06 pm

I asked my PS what type of sutures he used to stitch the muscles. They are called ethibond which I gather is permanent. One had come to the surface on my last visit and he took it out. The bump is getting better now. I still have around six of these bumps on my face. He still has me on tetracycline 500 mg twice a day. He wants to see me the beginning of the year. I feel like he is just putting me off until he can do something real about it. These are permanent sutures and they have to either get well or come out. They aren't going away so I figure he knows I need to have them removed. My PS told me on my last visit which was two days ago that I wouldn't need them replaced since it has been 14 months since my face lift. Is this true? If he completely removes the stitches what will happen to my face? I don't think I trust him. I don't know if he is telling me the truth or not. I don't know what he is waiting for. If they aren't going to get better then he should set up a time to remove them shouldn't he? I am in a panic. I don't want to go back in and be cut up again. Who would?
I have searched and searched the internet for anyone else that has had this problem. Is it very rare or something? Sorry if I sound so down. This has been a very long 14 months for me. Thanks for your reply, Dawn
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Postby Dr_Naderi » Sat Nov 17, 2007 6:28 pm

Hello Dawn,

Unfortunately Ethibond does have these issues and its not that rare. What is also not rare is that many Plastic Surgeons still use Ethibond routinely. Personally I have never used it and refuse to do so. What's more important is that I have said again and again that permanent sutures are completely unnecessary in facial plastic surgery. It is scar tissue that will hold up a lift and not sutures. So he is correct that the removal of the sutures specifically will not affect the lift results. But the question is how is he planning on removing them? Is he going to give you several new scars in the middle of your face or is he going to redo the entire facelift incision to gain access to the area? It is not a simple to remove sutures that have not poked out through the skin. Digging for them can be more traumatic than called for. You should see what some other surgeons recommend who have had a chance to examine you.

Keep me posted.
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

www.RhinoplastySpecialistSurgeon.com


[Online replies to questions are NOT a substitute for actual consultation & exam & should not be considered "medical advice."]
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Postby dawngurl » Sun Nov 18, 2007 11:26 am

Dr. Naderi,
Thank you so much for the reply. I don't know what I would do without someone to talk to that has a little knowledge on this. I trusted my PS to start with. I thought I had done all the research I needed when I went in for my FL. I researched for days online. I never saw anything about types of stitches used and bad reactions. There should be more on this under possible complications, I had no idea. If I had I would have asked him about it. I asked him about a million questions. I tried to be so careful.
He (PS) told me he would have to go back in and take them out. He said it would be just like getting another face lift. I don't want to have to do that and I could tell he didn't want to either (work for nothing) ; ). That's why I think he is leaving me sitting and taking tetracycline. I don't think these are going to come out on their own. He is trying to make me think they might. It's the holidays and he may be too busy to do a face lift for nothing. So he is holding me off with the antibiotics until the first of the year. My fear is that this could lead to a bad infection or bad scars. I already have two scars now. Should I go to another PS to see what can be done or should I just wait and see. Is he wrong to think the stitches will work themselves through after a while.
Thanks again for taking the time to answer. Dawn
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Postby Dr_Naderi » Sun Nov 18, 2007 3:09 pm

Hi,

I cannot tell you what to do without seeing you. But taking antibiotics and "cooling an infection or inflammation" is not a bad idea before surgery. There are many many patients who have Ethibond and have no problems. So you cannot blame yourself or your surgeon for that matter. I am sure if he had such frequent issues with the suture he would have changed his technique long ago. It never hurts to see other surgeons and see what they say. Good luck
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

www.RhinoplastySpecialistSurgeon.com


[Online replies to questions are NOT a substitute for actual consultation & exam & should not be considered "medical advice."]
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Thanks

Postby dawngurl » Mon Nov 19, 2007 5:34 am

Thanks for your help. As I said, I have been going through this since March of last year. I blame my doctor for leaving me in this state for all this time. I think something should have been done by now. My patience has worn very thin, as anyone would feel by now. When I went to him in March all he told me to do about the bumps was "don't mash hard on them and be careful around them" Well, how long do I do that, for the rest of my life? For nine months I sat with these bumps coming up on my face until I got sick of it. He wasn't going to do anything until I kept making appointments with him. I blame him for that, sorry if it sounds bad, but I paid him what he wanted for the procedure the least he could do is help me when things go wrong.
You have been very helpful. Yes, I will go to someone else and see what to do. I will also see what can be done about the material used for these stitches. It shouldn't be right to sale something that can turn out so bad for someone. Dawn
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Postby Dr_Naderi » Mon Nov 19, 2007 2:56 pm

Hi Dawn,

I totally understand your frustration. The fact that you feel abandoned and ignored is not right. But I also know that the solution is not an easy one. For him to just suggest to go right back in and reopen your facelift incision to hunt for sutures isn't a straight forward decision although at times it becomes the only viable solution. He should stand by you and take care of you. As far as the sutures, they are very commonly used by many plastic surgeons so he hasnt done anything wrong there although personally I do not like using permanent sutures in the face because even if outcomes such as yours are rare, they do occur and should be avoided and can be avoided if Plastic Surgeons use absorbable sutures.

keep me posted on your progress.
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

www.RhinoplastySpecialistSurgeon.com


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Thanks

Postby dawngurl » Mon Nov 19, 2007 7:59 pm

Dr. Naderi,
Thank you for taking time out of a very busy day to answer me. At least I know what it is now. For months I didn't know what it was. One day I will laugh about this.........I hope. I like my PS, I really do and wouldn't ever do anything to hurt his practice without a very big cause. Thanks for being understanding. I wish I lived in VA I wouldn't have this problem right now. :wink:
I will keep you posted. For now Happy Holidays to you!
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Postby Dr_Naderi » Mon Nov 19, 2007 8:58 pm

Happy Holidays to you as well... :)
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

www.RhinoplastySpecialistSurgeon.com


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Stitches removed tomorrow

Postby dawngurl » Mon Mar 17, 2008 8:33 am

Hey Dr. Naderi,
I don't know if you remember me. I am finally getting the stitches removed tomorrow. It has been a long year and four months for me. The marks on my face have gotten worse even with the tetracycline. I dread having to have a face lift twice....but some skin is just plain stubborn :wink: joke. I'm glad it will be over this time tomorrow and I can stop using cover up cream on my face. It has become a regular thing I tote in my purse like a security blanket. YAY!
I won't ever use this PS again since I don't trust him any longer. A patient needs to trust the person that is cutting on them. I am afraid he might not get all the stitches out and I will have to be cut open again. I am hoping he will have more mercy on me than that. The fact that he doesn't mind how his staff treats his patients makes me feel like he doesn't care about me as a patient or a person. I hope I am wrong about this.
I know for a fact I am not the only one that is treated bad there by some of the staff. I have several friends that have had procedures. One of my friends was embarrassed because someone in his office told a few people about her procedure, which I thought was suppose to be kept confidential.
Thank you for helping me. You have been a great help to me. Dawn
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Postby Dr_Naderi » Mon Mar 17, 2008 4:05 pm

One of my friends was embarrassed because someone in his office told a few people about her procedure


That is horrible and a HIPPA violation. Unfortunately there are some unpleasant staff and plastic surgeons out there. Many doctors are too hands off and do not take pride in how their office or staff run and rather only care about the bottom line. Other plastic surgeons run a very smooth and tight ship and make sure their patients get a great experience from the office staff and the office setting.

I hope your surgeon will be able to find all the offending sutures. Sometimes its tough as the sutures may be engulfed in scar tissue.

Good luck
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

www.RhinoplastySpecialistSurgeon.com


[Online replies to questions are NOT a substitute for actual consultation & exam & should not be considered "medical advice."]
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Postby dawngurl » Tue Mar 25, 2008 2:07 pm

Hi Dr. Naderi,
Today is a week since my procedure to remove sutures. It took about two and half hours and I have a scar in front of my ears and behind them going into my hair line in the back. I was suppose to put neosporin on the scars three times a day. Two days after the procedure I had two mirrors and was looking at the scars behind my ears. On one side I noticed an opening about 3/4" long, it was wide open. I called the PS office. I had to leave a message so someone could call me back. I left a detailed message. It took them about five hours to call me back. I kept calling in between but couldn't get anyone that knew what to do to talk to me. I was really upset about it. I had to go to the dr's office and have sutures. I don't think this part of my scar ever was closed up with sutures. I didn't notice any little holes on the sides of it where a needle had been placed. I don't know for sure but I think if the sutures had been pulled out the scar would have looked like it was sewn up to start with.
And as my luck would have it, my insurance only paid 90%, so I owe $450 for all of this misery. :roll: .
One thing that is good is I can look in the mirror and not see red bumps all over my face for the first time in a year. YAY!
My face looks pretty good right now. Of course there is still some swelling in my face. I hope I don't wake up one day and it looks like a balloon with the air leaked out of it. :lol:
Thanks for your help Dr. Naderi. Dawn
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Postby Dr_Naderi » Tue Mar 25, 2008 7:32 pm

You're welcome.

Keep me posted.
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

www.RhinoplastySpecialistSurgeon.com


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