A few notes on both topics.
Today, what the swelling looks like after a buried-suture removal.
A patient asked recently in consultation how much swelling to expect after removal.
I do not normally photograph or document the post-removal stage, but with this patient's consent for photos and video I will write it up.
Some patients worry that removing buried sutures (natural-adhesion technique) leaves significant swelling. Because we do not disturb the surrounding tissue and only locate and remove the suture itself, the lid does not swell much.
One caveat: the suture has to have been placed with a single-knot technique. With a multi-knot technique, we can release the crease through several small access points but not necessarily remove the suture.
In the photo above, you can see a band of adhesion above the black suture.
The suture extracted cleanly. Almost no bruising.
After suture removal, with a few interrupted skin closures.
Most patients who come in for buried-suture removal had a natural double crease originally and want to remove sutures from a second buried-suture procedure that left their crease looking faded.
Once they undergo that second surgery, however, the result often does not match what they had hoped for — a sausage look or multiple folds. An incisional approach would often have been the better choice.
Video showing the swelling. She had a natural fold beforehand, so you can see that the deep, pinched look is gone.