How long after surgery until eyelid stitches dissolve?

Tags:woman age 35-44 upper eyelids 1 week post-op recovery

Does it usually take longer than a week for stitches to dissolve after eyelid surgery? I’m just over a week now and they are still there. I thought I remember my doctor saying it could take up to 10 days. Does that sound right?

rogue123

M, 41, New York

Absorbable sutures are frequently used after upper eyelid and lower eyelid surgery. There are many different types of dissolvable stitches surgeons can choose from, each lasting varying time periods and of differing thicknesses. The most commonly used sutures in cosmetic eyelid surgery are known as 'fast absorbing gut sutures', and normally dissolve within 7-10 days. These dissolvable sutures are often used in areas where tension has been relieved by additional non-dissolving sutures under the skin's surface that may need to be removed later by your surgeon.

Eyelids generally heal quickly and many patients only require absorbable stitches for a week on their upper eyelid crease or lower eyelid skin. After this period they generally begin to lose their structural integrity and break down on their own. Some surgeons may choose to remove absorbable stitches after this period if they have not been absorbed as they can irritate the skin, leave small tracks marks on the sides of the incision, and cause a thicker scar.

However, it’s equally important not to remove eyelid stitches too quickly as the incision site may not be properly healed and the skin weak. While it may look like nothing is happening, the body digests the suture material underneath the skin before the exposed part of the suture thread begins to break down.  

Only your surgeon knows the details of your surgery and what is best for you, so if you feel concerned about your stitches, seek advice from him or her. They will remove the stitches once they’re confident they are no longer necessary. Do not try to remove stitches yourself at home; any removal of eyelid sutures should take place in your surgeon's office. You can, however, assist the healing process. Keeping the incision site moisturized with an antibiotic ointment or petroleum jelly helps to speed up your recovery and prevent the incision from scabbing or drying out.

There is a wide variety of dissolvable sutures used in plastic surgery that break down at different times. Some begin to dissolve after 3 to 5 days, while others can take weeks. When performing eye lifts or blepharoplasty surgery, surgeons most commonly use dissolvable stitches that break down after 5 to 10 days.

Surgeons try to find a balance between using stitches that dissolve quickly and stitches that last longer -- those that dissolve quickly tend to be less likely to leave stitch marks, while those that last longer help the incision to heal well and encourage the skin to become strong.

It sounds as if your surgeon used fast absorbing stitches to suture your eyelid incisions. On average, you can expect these stitches to take eight or nine days to dissolve as it takes time for the body to break down the proteins in the suture. Some plastic surgeons use a different, stronger type of suture on the inner part of the lower eyelid that takes longer to break down.

The dissolution begins in the areas beneath the skin before the externally apparent part of the stitch begins to break down as well. This means that while it may appear that nothing is happening and the stitches are not dissolving, they may be sitting on top of your skin yet no longer connected beneath the skin.

I would recommend waiting at least ten days following surgery to give the sutures adequate time to dissolve. If they are still visible after this and bothering you, contact your surgeon. He or she may be able to remove them, or advise you if they intend for them to be left in for a longer period of time. However, most surgeons remove external sutures after ten days to avoid scarring. Some plastic surgeons also recommend that their patients rub an approved antibiotic ointment along the incision line to help the sutures dissolve more rapidly.