What does sutures under the skin to avoid stitch marks mean?

[letsfixthis]

Hello.

I read on a plastic surgeon's website that with gynecomastia surgery, their method uses

sutures under the skin to avoid stitch marks

Does anyone have any clue on exactly what this means or how this differs from traditional gynecomastia stitch methods when closing the incision point after gland removal?

Thanks.

[Paa_Paw]

The body reacts to some kinds of suture materials similar to the way it reacts to a splinteror other foreign body. The area around the suture becomes a festered secondary wound. The extreem of this would be a wound that looks like a ladder with the rungs of the ladder being the stitches. Such materials are not in common use these days.

Modern suture materials are better tolerated and do not scar to the same extent even though the the stitches do need to be removed.

There are other kinds of suture materials that the body can not only tolerate but can actually absorbed over time. They do not have to be removed at all. With these materials, The stitches can be hidden within the wound and they will never show.

I really do not know what the big deal is. All three kinds of material have been around for over 50 years.

The braided silk suture that I would have used in the ER as an Air Force Medic over 55 years ago is probably not even available these days as there are so many better products now available. 

[letsfixthis]

The body reacts to some kinds of suture materials similar to the way it reacts to a splinteror other foreign body. The area around the suture becomes a festered secondary wound. The extreem of this would be a wound that looks like a ladder with the rungs of the ladder being the stitches. Such materials are not in common use these days.

Modern suture materials are better tolerated and do not scar to the same extent even though the the stitches do need to be removed.

There are other kinds of suture materials that the body can not only tolerate but can actually absorbed over time. They do not have to be removed at all. With these materials, The stitches can be hidden within the wound and they will never show.

I really do not know what the big deal is. All three kinds of material have been around for over 50 years.

The braided silk suture that I would have used in the ER as an Air Force Medic over 55 years ago is probably not even available these days as there are so many better products now available. 

Thanks for the great info. I guess someone should always check to make sure these are the stiches being used on them.

The part I was really asking about was it being under the skin. I have seen the ladder pattern before on tv but in gynecomastia surgery, they do it so if there was a ladder pattern, it would be " under the skin"?

Is this something that all plastic surgeons do or is this something special?

Also, very interesting about the Air Force Medic. Did you ever run into Ron Paul? I think he may have been an air force doctor back in the day.


Thanks.

[Paa_Paw]

Strictly speaking, anytime tissue is cut and then heals there will be a scar. The trick is to make the scar as small as possible and, when you can, put it someplace out of sight. So, yes there will be scars on the inside. Initially, they will sometimes be quite firm but they will soften in time. The visible scar will often be hidden by placing it in a fold of the skin where it will not show. In male breast reduction, the incision is usually made along the edge of the areola where the difference in colors and textures of the skin will hide the scar quite successfully.

[letsfixthis]

Strictly speaking, anytime tissue is cut and then heals there will be a scar. The trick is to make the scar as small as possible and, when you can, put it someplace out of sight. So, yes there will be scars on the inside. Initially, they will sometimes be quite firm but they will soften in time. The visible scar will often be hidden by placing it in a fold of the skin where it will not show. In male breast reduction, the incision is usually made along the edge of the areola where the difference in colors and textures of the skin will hide the scar quite successfully.

In the case were the liposuction and gland extraction are made from the same incision, should the liposuction not be causing a separate scar from the incision made for the gland extraction?

In other words, both procedures to reduce gynecomastia being made from the same incision opening in the skin?

The reason I ask is because I have seen one pictures were they appear to be 1 incision on each side however I have seen other pictures which look like a liposucion rounded hole and as well as a long scar around the areola.

Just wondering if the rounded hole could have been avoided if the long incision was made first and then used for lipo.

I think that is what Dr. Bermant did but I'm not 100% sure.

Thanks.

[Tonytony]

I am due to have my surgery in a month and will need to have some skin removed also. This will involve some stitches made from Gortex which hold the skin together from underneath, and will be there for the rest of my life. Sounds interesting, but I wonder if there might be problems down the line at some point? How sturdy are they? Does anyone have any experience with this or know of any?

[Paa_Paw]

I think you worry far too much about a very minor detail. This could cloud the important issues like the qualifications of the surgeon.

[letsfixthis]

I am due to have my surgery in a month and will need to have some skin removed also. This will involve some stitches made from Gortex which hold the skin together from underneath, and will be there for the rest of my life. Sounds interesting, but I wonder if there might be problems down the line at some point? How sturdy are they? Does anyone have any experience with this or know of any?

Hi.

I think I may have phrased it poorly, I was just talking about the regular gynecomastia surgery incision for lipo and gland extraction. I did not mean like removing excess skin.

Sorry about that.