Disposable Stitches For Beverly Hills Nasal Surgery

Nasal surgery can be performed either as an open rhinoplasty or closed rhinoplasty.  Open rhinoplasty implies that there is an incision made on the nasal exterior between the nostrils and sometimes at the junction of the walls of the nostrils and the cheek in addition to internal hidden incisions.  Closed rhinoplasty is the title for a cosmetic nasal plastic surgery that is done entirely through hidden incisions within the nose.  The choice of surgical incision approach depends on the experience and training of the surgeon.  Excellent results can be obtained by either procedure in the hands of the skilled, experienced surgeon.  My observation is that those surgeons who have been in practice longest, who have the largest case volume, the greatest experience and highest degree of specialization – the superspecialists – favor the closed rhinoplasty.

Closed Rhinoplasty Performed by Dr. Kotler

In open rhinoplasty, the incision may be closed with what are known as “permanent” sutures (stitches).  Permanent is a misnomer; these sutures unless those placed internally into a body cavity such as the abdomen, are not permanent; they have to be removed.  But in closed rhinoplasty, since all the incisions are placed on the interior and would be more difficult to remove because of their hidden location, absorbable or “disposable” sutures are placed. 

There are a variety of sutures which may be used, everything from synthetic, man-made sutures, to sutures known as “catgut” or “gut”.  Such sutures are processed from lamb intestine. Catgut sutures treated with chromium are known in the surgical world as “chromic sutures”. Such immersion in chromium allows the sutures to resist digestion longer and thus remain longer to encourage healing.

Suture selection is made depending on the desired duration of the stitches holding the tissue together or closing incisions.  For some particular cases, say tummy tuck, it is important to have the stitch stay in place for several months until strong internal repair tissue is formed.  Typically for closed rhinoplasty incision closure, five to ten days of presence is adequate.  The process of dissolution of the sutures is automatically performed by the body. It silently attacks and digests them since they represent a foreign material.  The process is hastened in a moist atmosphere, hence the reason to use the saline or salt water nasal spray after cosmetic nasal surgery or reconstructive surgery such as nasal septoplasty and turbinate resection to correct nasal obstruction.  Likewise, the A&D ointment when placed inside the nostrils will keep the stitches remaining soft and less brittle-like and, therefore, better tolerated by the patient.