Thank you for your question! You submitted a single photo with a question about whether or not it’s normal to have thickening of the incision line one month after surgery secondarily caused by as you described dissolving stitches and you described in your question that you live in a different state from the cosmetic surgeon who performed the surgery. Well I can give you some guidance as to how to interpret this situation. I’m a board certified cosmetic surgeon and a fellowship trade oculofacial plastic and reconstructive surgeon, practicing in Manhattan in Long Island for over 20 years and Asian.
Eyelid surgery is an area focus in my practice area of expertise. I can certainly give you some guidance based on just the single photo. So what do we see We see an incision line and we see an area of the inner aspect of the incision line that is thickened one month after the surgery. Well, clearly this is an incisional Asian eyelid operation and the question that I would have is were there nondissolving sutures and were those nondissolving sutures removed about a week later or was the plan that you would have nothing but dissolving sutures.
Since you are not from the area and that dissolving sutures would dissolve on their own. Now this is an important distinction and an addition whether or not your surgeon felt it necessary to engage the inner part of your eyelid with deeper stitches that are placed to connect the skin to a muscle called levator muscle. You see whether you do the procedure as a nonincisional or incisional Asian eyelid surgery, your goal is in order to define the crease and to create some long term connection between the skin and the levator muscle and.
Asian Eyelid Surgery the Role of Dissolvable Sutures in Surgery, and in Healing
This is the muscle the lifts the eyelid and defines the crease. Now use of dissolving stitches to engage the skin to the upper level of the tarsus the backbone of the eyelid as well the levator muscle is something that is done. Now the type of stitches can be something called plain gut suture or can be another suture called Vicryl suture. Now these sutures dissolve in different rates and certainly they can some bumpiness and irregularities. When you think of wound healing is the first month of wound healing is referred to as the proliferative phase. The body is generating a lot of collagen,.
Blood supply. It’s a very active production in healing process. Now with this incisional alone, that I would say that most likely it would just flatten out and smooth out because that’s what happen in any incision but the fact that you had stitches that were dissolving, I am not sure based on the photo whether those dissolving stitches are responsible for the thickening or whether it’s just normal wound healing. A lot of times like for ourselves there is a pattern of practice that every doctor has and the experience that comes from doing that practice so if you are doctor used dissolving.
Stitches routinely then they should be probably familiar with how someone responds during the first month, second, third, fourth and beyond. So, although I could say, yes it’s possible that it is from the dissolving stitches and that it is likely to improve since I don’t know more details, I think it is still important to communicate with your doctor and ask about this situation, this incision because your doctor most likely has a process especially for people who come from out of town just as we do. A lot of our patients come from.
Around the world for eyelid surgery, for face lifting surgery, for hair loss treatment and there is a lot of reasons to travel but with all those procedures that we do, we have a process and a system and a familiarity of what to expect after the treatment. So I think the same should apply for the doctor who performed your surgery. So speak to your doctor show, send the pictures, and keep that communication going. It’s only been a month since the surgery and although you are looking for additional opinions, I.