Hi Dr. Naderi:
I read your interesting forum at some plastic surgery site, but I could never figure out how to post a question there. I was especially interested in the discussion about dissolvable versus standard sutures. I had a surgery on my ear and nose (mole removal), and the excisions were closed with standard stitches. A week ago I came to remove them and felt a lot of pain. Something obviously went wrong: either the surgeon did some damage as she was pulling out a suture or my scar didn’t heal yet, I’m not sure. She told me that she had to use some meds now that are going to help the newly open scar heal. This medication is dark color and I’ve been having burning pain for several hours after it was applied. What does this all mean? Would I be better off with dissolvable stitches? And how that medication is going to affect scar formation? Is it going to be more visible after that?
Please advise! I’m really worried.
I am not sure what your incision, wound or scar looks like and without you sending me some pictures via email, its impossible to go by just a description.
What I can tell you is that mole removals from the nose or ear depend are followed by closure with a layered closure. Plastic surgeons place 2 to 3 layers of suture deep below the skin to remove the tension off the skin itself. That way, the sutures on the skin aren’t working that hard to hold the edges together and can therefore be removed in 3-7 days in order not to leave suture marks on the skin.
The deep sutures are most often dissolvable although some surgeons use permanent sutures.
The ones on the skin can be dissolvable or permanent. The suture placement and thickness is as important as the suture material. There are some areas that dissolvable work much better and other areas that permanent sutures yield better results. The skin type (sebaceous or thin) is also important.
At the end of the day each patient heals differently. Pain with suture removal may not necessarily be a sign of something going wrong. It sounds like the surgeon used Silver Nitrate to burn something on you.
Again, the description is very vague and unless you email me pictures I cannot tell you much more. You can see another surgeon for a 2nd opinion though to make sure you are healing in the right direction.