Figure 7.

Interrupted buried 3–0 Monocryl sutures are used in the deep dermis. The skin is closed with a subcuticular 3–0 Monocryl. I am using less gathering now with this suture. Not only does it take the pucker longer to settle, the vertical skin stretches out with time in spite of the gathering. If the skin has poor elasticity, then some gathering may be indicated but only at the inferior aspect of the vertical incision. Excess gathering causes a teardrop-shaped areola in the initial postoperative stages and it could constrict the blood supply to the skin, causing wound-healing problems at the skin edges. Care must be taken not to take deep constricting bites of dermis when this suture is gathered.