Facelift - How many stitches are there?

Who is doing the surgery and what technique they are using will determine he number of stitches. Suffice to say, there are MANY stitches used to support the deep tissues, tighten the muscles, and close the skin. How many doesn't really matter - just that you get the result you want.

If someone is trying to sell you a facelift based on the number of stitches, I would recommend going to someone else. The number of stitches used during a facelift is individualized for each patient and judging a facelift by the number of stitches is irrelevant. Facelift surgery is very complex. It is more how you put the stitches and where you put the stitches than how many you use.

I hope this is helpful.

David Shafer, MD
Shafer Plastic Surgery

As a plastic surgeon I get this question a lot. For me, it does not matter how many sutures I place. I place a many as I need to get the desired result.

Lets talk about this question a bit more. A few years ago I had read a study that compared 2 groups of patients. One had a small incision covered with a Band-Aid and the other the same incision covered with a big bulky dressing. The patients from the first group had less pain complaints and recovered faster.

Perception may not be everything but it is very important. Some patients feel that the more sutures we place, the more complex and more extensive the surgery was. In Plastic Surgery we tend to use smaller sutures and smaller needles that are more gentle on the tissues. So, in most cases I would place more sutures in the wound than, say, a primary family doctor. No offense to your family doc.

I feel that smaller sutures placed closer to each other bring the tissues together better and as such creates better and smaller looking scars. But this is just an opinion.

However, there is a more important issue to discuss. When we bring deep tissues together with sutures that dissolve on their own, we rely on the body's ability to dissolve them. Some patients are unable to fully dissolve some suture materials and start "spitting stitches" after surgery.

That is why for facial cosmetic surgery we try to use enough of those deep sutures to hold the tissues in place but not too many to overwhelm the body's ability to dissolve them.

After a comprehensive full face/neck lift, 40-50 stitches are used to meticulously close the incision site at the hairline, in front and behind the ears. These stitches are removed at the fourth day after the surgery to avoid railroad track scars along the incision line.

The incisions themselves are not closed under any tension because the tension is placed on the muscle layer and the SMAS layer underneath. So the skin is pulled together very gingerly, which prevents the wind-tunneled or operated look, and patients heal very naturally.

The number of suture or stitches depends on the length of the incision. The length of the incision is based on not only the type of facelift that is being performed but also the individual's particular anatomy.

The short-scar facelifts require much smaller incisions and therefore fewer stitches. On the other hand, a full face and neck lift, will require longer incisions and therefore more sutures.

Typically, the exact number of sutures are variable based on each surgeon's closing techniques. In general, as long as the incisions are closed in a meticulous fashion, the number of sutures has very little impact on the outcome.

Furthermore, for patients who don't like the idea of removing stitches, absorbable stiches can be used.

The stitch count is not important. It is the quality of the closure and the precision with which it is performed that will make the difference.  Quite honestly I never count, I just try to do a great job!