In breast augmentation surgery, the incision is closed with sutures, commonly known as stitches, to hold the tissue layers together and allow for proper healing. The stitches are placed in multiple layers, starting with the deep tissues and ending with the skin surface. Understanding the fate of these sutures is a common concern for patients. The healing process involves the body absorbing some of these materials while others may require removal.
Understanding Suture Materials
Surgeons typically use two main categories of materials for wound closure: absorbable and non-absorbable sutures. Absorbable sutures lose their tensile strength and break down naturally within the body, eliminating the need for a removal appointment. These are often composed of synthetic polymers like polydioxanone (PDS) or polyglactin, or natural materials like chromic gut.
These dissolving stitches are primarily used for closing the deeper layers of tissue, such as the fascia, muscle, and subcutaneous fat. The body breaks down these materials through hydrolysis or enzymatic degradation, a predictable process that varies depending on the specific material used. Non-absorbable sutures, made from materials like nylon or polypropylene, remain intact and are generally used for skin closure. The use of non-absorbable sutures on the skin can sometimes result in a less reactive healing process, potentially leading to a more favorable scar appearance.
The Typical Dissolution Timeline
The timeline for suture dissolution depends heavily on the material’s composition and placement within the tissue. Absorbable sutures on the skin surface, often used in a subcuticular closure, may start to become less visible or “fall out” within one to three weeks after the surgery. However, this early fading does not represent complete absorption of the material.
The deeper, structural sutures used to hold the internal tissues together take significantly longer to fully metabolize. For example, sutures made from PDS may lose most of their strength within 6 to 8 weeks, but the material itself can take anywhere from three to six months to be completely absorbed by the body. Sutures made of polyglactin may take approximately 90 days for full absorption. The initial breakdown allows the body’s new collagen matrix to take over the work of wound support.
Factors That Influence Healing Speed
Several factors related to a patient’s biology and the surgical environment can influence the rate at which sutures dissolve and the incision heals. A patient’s metabolic rate plays a significant role; individuals with a faster metabolism may break down the suture materials more quickly. The patient’s nutritional status is also important, as a healthy diet rich in protein supports the body’s ability to generate new tissue.
The surgical technique and the tension placed on the incision line are also influential variables. High tension on the wound edges can place more stress on the sutures, which may lead to earlier degradation or complications. Smoking is another factor known to significantly impair the healing process because nicotine reduces the oxygen supply to the healing tissues. This reduced oxygenation can slow down the entire recovery process.
Post-Suture Care and When to Contact Your Doctor
Proper post-operative care is essential to support the healing process while the sutures are dissolving. Patients should follow the surgeon’s specific instructions for incision care, which typically involves keeping the area clean and dry. Surgeons advise against submerging the incision in water for at least two weeks to minimize the risk of infection.
Physical activity restrictions, such as avoiding heavy lifting or strenuous exercise for several weeks, prevent strain on the dissolving sutures and the fragile new tissue. Patients should monitor the incision site for signs that may indicate a complication, such as a localized infection. These signs include increased redness, warmth, excessive swelling, or unusual discharge.
Sometimes, a dissolving suture will be pushed out of the skin before it is fully absorbed, a phenomenon known as “suture spitting.” If a small piece of suture material becomes visible or causes persistent discomfort, the patient should contact their surgeon. The surgeon can easily trim or remove the exposed portion in the office, and patients should never attempt to remove the stitches themselves.