Stitch Removal

[Raphael84]

Would just like to hear any experiences regarding patients who had to have their donor site stitches removed, by somebody other than their HT Doctor. How did your local GP feel about removing them? Pain? Did any GPs refuse to take them out?

Having just undergone my surgery with Dr Rahal, I have returned home and need to get the stitches out next week. Interested to try and gather as much information as possible!

[gillenator]

Most physicians have formal training on suture removal but not necessairly staples.

 

Sutures really are not hard to remove and many clinics have techs remove them verses the doctor doing it post-op. Any out patient medical clinic should have someone who can remove them. But you are probably going to be charged for them to be removed.

 

Or if you live in my area DC, I would be more than happy to remove them free of charge!

[Shampoo]

Raphael84...I was at my plastic surgeon's office early last summer getting a shot of botox for an eyebrow furrow and told him that I was having a hair transplant in Canada in August. He said "sure come by and I will take them out". So before my surgery I made an appointment with him for ten days post-op. He took mine out in less than 5 mins and afterwards he said "no charge". That was pretty cool. However I did find two days later that he had left one staple in and I had to go back....no biggie. He was pretty embarrassed and apologized about missing one. Someone else on this message board said they too had a doctor miss one staple. BTW....my staple removal was 100% painless and went very easy. Made a huge difference in sleeping and in comfort in general.

[gillenator]

shampoo,

 

You might be thinking of my post when one of my staples got lodged under the epidermis as the sutured area healed.

 

Most of my staples came out without much effort and several were difficult and my doctor had to really work at it. Those were very painful and yet no numbing of the area.

 

I have observed that it helps to spray the stapled area with warm saline water 10-15 minutes before removal to soften up the tissue before the staples are removed. The instrument used looks alot like a staple puller used in the office!

[Shampoo]

You might be thinking of my post when one of my staples got lodged under the epidermis as the sutured area healed.I have observed that it helps to spray the stapled area with warm saline water 10-15 minutes before removal to soften up the tissue before the staples are removed. The instrument used looks alot like a staple puller used in the office!

 

gillenator...yeah that may have been you. Hasson/Wong advised taking a long hot-hot shower as close to time of staple removal as possible to soften tissue as well....and I did that...who knows maybe it helped. Also a couple of times a week I was taking the Hasson/Wong advice to apply Vitamin E oil all over my scalp post op...I was letting it sit for an hour or more and that seems to soften scalp as well. Mine went extremely easy, but I am sure every patient is different.

[gillenator]

Good point about the vitamin E which many HT docs recommend post-op.

 

It's also the crusting around the sutures that softens along with the tissue so I also use the warm saline spray whenever I remove sutures for patients too. I find that standard sutures and ones made of polyester are not an issue for removal compared to staples. Still, anything that makes the removal less painful is certainly of benefit to the patient.

 

I remeber a patient from MPLS that came to my office for staple removal and they were the toughest to remove. In fact, several of the staple removers began to bend and the staples never opened up! I felt soooo bad for him because it was painful and I ended up referring him back to his doctor but I think he went to his local out-patient facility covered by his insurance. It may even be advisable to consider the use of a local anesthesia in the stapled area if they are stubborn to remove.

 

Yet I have helped probably a dozen or so patients for staple removal and they went very smoothly with just a few stubborn ones.

 

I will say this, every patient that I ever removed staples for had a very thin and tight smooth scar as a result from having the staples. So although there can be some discomfort, in the end a thin scar was worth it.

[Raphael84]

Gillenator, Thanks for the feedback and the offer, but I possibly could not be further away from you DC, but very kind nonetheless.

 

Thanks for the input guys. Have booked into a private surgery for early next week, so shall be following your advice with the hot water on the area, and saline spray, and will hopefully have a very easy time. I shall let you know!

[Shampoo]

Good point about the vitamin E which many HT docs recommend post-op.

 

gillenator....I'm not sure if the Vitamin E is the reason, but I have been surprised how little hair has shed post-op. I kept waiting for the big shed. To be honest I have seen none shed....but I guess the transplanted hair must shed? Do you know if in 100% of the cases all the transplanted hair sheds?

[Raphael84]

Stitches removed! Feels good to finally get them out and to have completed the clinic visits. No pain. The odd little pull here and there, and the clinic were obviously very interested to know how I had "gained" such a scar. From now, no more appointments. Just me and my body to heal and grow.

[TommyLucchese]

My sutures were a nightmare.

 

I had the removal tool and my parents took them out, but even after 2 weeks they didn't seem ready to come out. Some came out easily, others came out after a big painful struggle. There was a period of 5 days where some wouldn't come out, but the next day they would. It all hurt though.

 

I've since read that it's better to soak your head in warm water first. Or maybe I just hadnt healed enough, I don't know.

 

[edit] when they are ready, you don't feel a thing though.

[Raphael84]

Tommy,

 

When you talk about the removal tool and for the fact that you had your surgery with Dr Feller, Im guessing that you had staples as opposed to sutures?

They seem to be more of a bigger deal to remove than the sutures, but at least you have the option of taking them out with the tool, at home. I didnt really enjoy going to an independent clinic and get quizzed by some Doctors regarding the whole procedure etc etc... It was no problem, and what I expected but would have preferred to stay home if I had the choice!

[rlc26]

I had a transplant with Dr Saifi in Poland last December and came back with sutures. I live in the u.k and went to a local walk in center, at first they asked if i was sure they wern't dissolvable because the sutures were so neat and tight.

 

After quite a wait i was took into a nurse who said she would have a go at removing them after a bit of prodding and pulling she got started, it was abit painful but was good to get them removed.

[StaggerLee123]

I'll be frank, when I had my stitches removed it hurt like hell. I went back to my clinic and one of the techs did it. Ouch!! I think staples are easier coming out but rest assured if it does hurt it will be over fairly quickly. Some numbing cream or something would have helped but not sure if they do that...

[TommyLucchese]

Tommy,

 

When you talk about the removal tool and for the fact that you had your surgery with Dr Feller, Im guessing that you had staples as opposed to sutures?

They seem to be more of a bigger deal to remove than the sutures, but at least you have the option of taking them out with the tool, at home. I didnt really enjoy going to an independent clinic and get quizzed by some Doctors regarding the whole procedure etc etc... It was no problem, and what I expected but would have preferred to stay home if I had the choice!

 

 

I honestly don't know the difference between sutures and stitches. I didn't quiz Dr. F about the technicalities of everything so I'm not sure. The post op sheet said sutures but they did look like staples.

 

Yeah I had the opportunity of going to GP or something but the thought of more people being exposed to my HT was not what I wanted. I don't think going there would have helped with the pain though, I followed instructions and watched youtube videos of how to remove it......it just felt like they mostly weren't quite ready to come out.

 

Still, not a big deal in the grand scheme of things....just a bit annoying at the time isn't it!

[gillenator]

gillenator....I'm not sure if the Vitamin E is the reason, but I have been surprised how little hair has shed post-op. I kept waiting for the big shed. To be honest I have seen none shed....but I guess the transplanted hair must shed? Do you know if in 100% of the cases all the transplanted hair sheds?

 

 

Shampoo,

 

Yes all of the transplanted hair sheds, but not at the same time. Some of the grafts take off and continue to grow in length. When that occurs, it is a sign that those follicles are still in their growth phase.

 

For most patients, a higher percent of the grafts shed post-op. Typically the hair within the grafts comes off with the crusts. When the grafts shed, that is a confirmation that those follicles went dormant. They will rest for 3-4 months and then re-enter the growth phase and begin growing a new hair shaft.

 

Take a close look at the crusts when they come off post-op. You will see a tiny stubble of hair within some of the crusts. That was the hair within the grafts. If you see crusts without the hair stubble, those are the grafts that remained in the growth phase.

 

Best wishes to you my friend and enjoy your new transition!

[gillenator]

Guys,

 

Sutures are sutures (stitches), and staples are staples.

 

Sutures are typically composed of thread or nylon, ployester, etc. And some are dissovable.

 

Staples are made out of a metal composite and IMHO, can be much harder to remove, and potentially more painful. I had both at different procedures and I would gladly have sutures over staples any day.

 

I truly believe that it depends on each seperate case as to which method of closue the surgeon utilizes. Again, staples are most often used when the scalp is a bit on the tighter side of laxity.

 

IMHO, the patient should never attempt to remove his/her own sutures or staples. It's very difficult to see the donor area and then to coordinate your hands. :rolleyes:

 

I have removed sutures many times and found that the suture involves one long line of thread. I typically start at one end where the knot is and cut that knot off. Then it's a simple matter of pulling through each suture with a forceps tool without ever cutting the line. I always ask the patient if they want to see the long line before I discard it and some guys want it so I put it in a zip lock bag for them to keep as a souvenier.

[Shampoo]

Guys,

 

IMHO, the patient should never attempt to remove his/her own sutures or staples. It's very difficult to see the donor area and then to coordinate your hands. :rolleyes:

 

I know a lot of guys do it and I suppose it works out ok, but like you suggest I would not even consider it. If I just spend close to $20K on a surgery why would I try to save $75-$150 instead of having a professional remove the sutures/staples?

[Brad3451]

My wife removed mine. Was sure to have the Dr. check closer at my 8 month check up. No big deal really as they gave me a removal kit. Best of luck.

[gillenator]

I know a lot of guys do it and I suppose it works out ok, but like you suggest I would not even consider it. If I just spend close to $20K on a surgery why would I try to save $75-$150 instead of having a professional remove the sutures/staples?

 

I could not agree more!

[Dr. Ricardo Mejia]

It is always a good idea to follow up with a medical professional. If all the stitches are not removed or if a portion is left under the skin, you may risk developing an inflammatory reaction or a stitch grqnuloma. Feel your scalp regulary and if there is any irregularity have it evaluated, I have seen several cases from other surgical offices where stitches were not completely removed.

[gillenator]

Possibly this can occur moreso when there has been a tryco or double-closure method involved? Really anytime sutures are invloved and why a follow-up with a medical professional is a good idea as Dr. Mejia pointed out.