What are dissolvable sutures?
Absorbable (dissolvable) suture materials are synthetically produced polymer threads that the body breaks down over weeks to months, enzymatically and by hydrolysis. No subsequent suture removal is needed — the suture holds the tissue together for as long as is required for a secure wound closure, and then dissolves without residue.
Non-absorbable sutures (e.g. polypropylene, nylon, silk), by contrast, remain in the tissue permanently and — in the case of sutures on the skin surface — have to be removed by the doctor after 5 to 14 days. Both classes of material have their indications; the choice is always a medical decision in the individual case, depending on the incision line, the tissue tension and the aesthetic goal.
Terminology
Absorbable sutures: what the term means — and how long they last
Absorbable sutures and dissolvable sutures are the same suture material — {absorbable} is the medical term (from the Latin resorbere: to soak up), {dissolvable} the everyday translation. What is meant are sutures that the body breaks down itself after the wound has closed: by hydrolysis, that is the splitting of the polymer chains by tissue water, and enzymatically. Operation reports, doctors' letters and packaging usually say "absorbable", in conversation we mostly say "dissolvable" — for you, both mean the same thing: no suture-removal appointment.
How long absorbable sutures last has two answers. The {holding strength} — medically the tensile strength — remains fully intact in the first weeks and decreases step by step from week 3 to 6, in time with the growing intrinsic strength of the healing wound. {Complete dissolution} takes considerably longer and depends on the material: polyglactin 910 (Vicryl) around 60 to 90 days, poliglecaprone 25 (Monocryl) around 90 to 120 days, polydioxanone (PDS) around 180 to 220 days. As a rule none of this is noticeable. Non-absorbable sutures — polypropylene or nylon, for example — by contrast remain in the tissue permanently and are removed from the skin surface after 5 to 14 days.
Which materials we use
We primarily use three classes of material, each according to indication: polyglactin 910 (brand name e.g. Vicryl) for deeper, layered sutures, with an absorption time of around 60 to 90 days. Poliglecaprone 25 (Monocryl) for intracutaneous main sutures directly beneath the skin surface, with a finer thread gauge and an absorption time of around 90 to 120 days — that is our standard for an inconspicuous scar line in the tummy tuck, the breast lift and the facelift. Polydioxanone (PDS) for layers under particular tension (e.g. deep fascial sutures), which at around 180 to 220 days has the longest tensile strength among the common absorbable materials.
All three materials have been clinically established for decades, are biocompatible and are used in microsurgery and plastic surgery worldwide. An allergy to the material itself is very rare; if it does occur, it is reversible and readily treatable.
What do dissolvable sutures look like? Colours and identifying features
Depending on the material, dissolvable sutures are dyed or colourless: polyglactin 910 (Vicryl) is typically dyed violet so that it stays clearly visible in the operating field — but there is also an undyed, beige variant. Poliglecaprone 25 (Monocryl) is usually colourless and transparent with a slight sheen; polydioxanone (PDS) is violet or clear. For skin sutures the thread gauge is in the range of tenths of a millimetre — considerably finer than sewing thread.
At the skin surface you normally see nothing at all of a buried, intracutaneous suture — it runs entirely beneath the surface of the skin. At most, short thread ends are visible at the entry points, looking like fine pale or violet hairs, or a small knot that can be palpable in the first weeks. Both are normal and disappear by themselves as the material is absorbed.
Wound healing — what happens when
Wound healing runs in four phases that merge into one another: the exudation phase (day 1–3) with wound closure and inflammation-related swelling; the granulation phase (day 4–21) with the build-up of new tissue; the epithelialisation phase (day 7–28) with the closure of the outermost layer of skin; and the maturation phase (month 1–12) with the gradual remodelling of the scar — redness fades, the tissue becomes softer.
Absorbable sutures accompany these phases: in early healing (weeks 1–3) they hold the tissue securely together. From week 3 to 6 the tensile strength of the material decreases successively — in time with the naturally growing intrinsic strength of the healing wound. By month 2 to 6 the material is completely absorbed. That is the clinically decisive point: the suture holds for exactly as long as the tissue needs support.
During absorption nothing is normally noticeable. Rarely, a small knot at the skin surface can be briefly palpable until it dissolves — that is harmless and resolves by itself.
What to do if a suture is poking out or does not dissolve?
If a thread end is poking out of the skin, or if a suture takes noticeably longer to dissolve than expected, the first rule is: do not pull it yourself, do not cut it, do not manipulate it. A protruding end of a buried suture can be connected to deeper suture layers — pulling on it can irritate the wound or disturb the line of the suture. Shortening or removing it is a job for the treating practice; it takes a few seconds and is as a rule almost painless.
Relatively common and harmless is so-called suture extrusion (a "spitting suture"): the body pushes a knot of the absorbable material towards the surface of the skin instead of breaking it down completely. It shows as a small pale dot or a palpable grain along the scar, sometimes weeks to months after the procedure. A suture remnant in the scar that looks ingrown is usually such an absorption phenomenon too, and not a complication.
You should have the site looked at by a doctor if redness, increasing swelling, pain, local warmth or discharge are also present — that can point to a local inflammation or a suture granuloma, which should be treated. The same applies if a suture is still unchanged well beyond the absorption time (2 to 7 months, depending on the material). For patients of our practice: simply get in touch briefly — the check is part of the follow-up care and is straightforward.
Comfort and scar appearance compared
From the patient's point of view the biggest difference is that the suture-removal appointment is no longer needed. For major procedures such as a tummy tuck or a breast lift, classic sutures would require several suture-removal appointments over 1 to 2 weeks — with absorbable sutures the follow-up care is reduced to wound checks alone.
In the appearance of the scar the difference shows at the intracutaneous suture: a buried, dissolvable suture leaves no needle tracks at the skin surface and avoids the dreaded "railway sleeper" pattern that can arise with superficially placed interrupted sutures. The end result is typically a hairline pale-pink scar and, after 6 to 12 months, a barely visible mature one.
Important: the suture material alone does not determine the scar. An incision along the tension lines, careful subcutaneous adaptation, a tension-free wound closure, abstinence from nicotine and consistent scar care in the first 6 months are the larger levers.
When we do use classic sutures after all
In regions of skin that are heavily loaded mechanically or very fine, we deliberately use non-absorbable sutures with classic suture removal — typical examples are the eyelids (upper and lower eyelid surgery) and the lip region (bullhorn lip lift). There, very fine 6/0 or 7/0 polypropylene sutures give the finest scar, because the thin suture material barely traumatises the skin as it enters and the targeted removal after 5 to 7 days closes the scar smoothly.
In patients with an increased risk of hypertrophic scars or keloids, a shorter time with external classic sutures can also be an advantage — we decide that together with you in the initial consultation (€100).
Which treatments we use absorbable sutures for
At our practice, dissolvable sutures are used routinely in the tummy tuck, the breast lift, breast augmentation with implants or fat transfer, breast reduction, the facelift in SMAS technique, the arm and thigh lift and Renuvion® skin tightening — wherever a buried, multi-layered suture line improves the appearance of the scar.
For upper and lower eyelid surgery, the bullhorn lip lift and buccal fat removal we use either absorbable or the very finest non-absorbable sutures, depending on the incision line and the location — we discuss the choice with you in the surgical informed-consent consultation.
Frequently asked questions
How long does it take for the sutures to dissolve completely? Between 60 and 220 days, depending on the material. Monocryl and Vicryl are absorbed in 2–4 months; PDS in up to 7 months. What is clinically relevant is not complete dissolution but the point at which the tensile strength falls below that of the healing wound — that is after 3 to 6 weeks.
Can you feel the sutures while they dissolve? As a rule, no. Very rarely a small knot is briefly palpable — it dissolves by itself within a few weeks. Pain or redness is not to be expected; if it does occur, please get in touch.
What happens if I react allergically to the material? Allergic reactions to modern synthetic suture materials are very rare. If they do occur (local redness, itching, impaired wound healing), they subside by themselves once the material has been absorbed and are readily treatable. If you have a known allergy to suture material, please tell us before the procedure.
Can absorbable sutures dissolve prematurely? Not when used as intended. Absorption is material-specific and predictable; we choose the material so that its tensile strength lasts considerably longer than the wound needs mechanical support.
Can the dissolving of the sutures be accelerated? No — absorption takes place by hydrolysis and is a fixed property of the material that cannot be meaningfully influenced by heat, ointments or home remedies. Actively manipulating thread ends is also to be discouraged: it risks impaired wound healing. If a palpable knot or a thread end bothers you, the practice shortens or removes the remnant in a few seconds.
Is scar healing with absorbable sutures equivalent to classic sutures? As a rule yes — with intracutaneous sutures it is typically even superior. In very fine regions of skin (eyelid, lip) the classic 5-to-7-day suture removal gives the finer scar, which is why we deliberately choose non-absorbable materials there.
