American Society of Plastic Surgeons
For Medical Professionals
4 years ago

Question for 13 month old large forehead cut and scar-time sensitive

My daughter is 13 months old. She got 6 stitches on her forehead today from a large cut. ER doc just did one top layer of stitches. Everything I’m reading online suggests we should have done two layers of stitches. Should we go see a plastic surgeon tomorrow. Is there anything they can do? Will her scar be a lot worse?

Procedure: Gender Affirmation Surgery
Location: sf, CA

Replies 2

Debra Johnson
ASPS Surgeon

It is often unnecessary to do more than a single layer closure in the face. Deeper sutures are placed to reduce the tension on the skin, and since there is very little tension in the facial skin, surface sutures are the only ones needed. On the face, I remove the surface sutures in around 5 days, to prevent railroad tracking by the suture entry/exit of the skin, and then tape the incision for about 4 weeks, changing weekly or as needed. The scar will be firm and red initially and will slowly soften and face. But that scar maturation will take up to a year, so be patient.

Robert Buchanan

The only absolute reason to do multiple layers is if multiple layers have been cut. At this point, the only thing you need to worry about is leaving the stitches in too long. They should come out at 4-6 days. The eventual scar will be mainly defined by the method of injury, sharp injuries having better scars than blunt injuries.


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