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-Marie, You also have to take into account the skill of the surgeon. Some surgeons simply cannot suture, and others simply do not care. You can have external sutures and still end up with a very nice scar---I am living proof 2x now. My neurosurgeon had to use an external suture on me because of my allergies to the other common dissolving sutures and the first time, not one person could tell I had a scar on my anterior neck, and this time it looks like it will be the same result. And the larger scar I have now on my hip from this surgery---I can tell it will heal very nicely and over time will be very small. Yet, when I had my open heart surgery done, the surgeon did an AWFUL job suturing and now the upper 1/2 of my sternal incision has those railroad tracks. Not to mention the scar is horrible because I had to be reopened 3 or 4x, but the surgeons simply didn't care about my scar at the time. My surgeon just wanted to get me better and healed. Plus, he will be the first to admit that he is not good at suturing. I have found that most physicians don't give a damn about how the scar will look, and don't even try to minimize the scarring. But, that is one of the things we need to be researching when we look for docs. Find out what their scars are like from previous pts. Do they make an effort to minimize scarring? And are pts generally happy with the scar? I know that one day I will have to see a ps to do a scar revision on my sternal scar, because it really isn't pretty. But just because you don't have only internal dissolvable sutures doesn't mean that you won't still have a nice scar. It all comes down to the skill and suturing technique of the surgeon. The technique my neurosurgeon used was all done subcuticular, which means it was just under the surface of the skin. He left "tails" on each end of the incision, so that it could be pulled easily. There are absolutely no railroad tracks or suture marks. Just a clean, well approximated very thin incision that already is fading. e ----- Original Message ----- From: perlesetlacet@... Sent: Sunday, March 10, 2002 10:12 PM Subject: Re: To Dr. Kolb Suturing techniques are important. I had outside stitches and have railroad tracks. The best surgeons will use internal stitching not metal suters like the kind my PS used.-Marie

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