Carrie Underwood is on the mend. The country singer just revealed in a post to her fan club that she needed stitches in her face after falling on the steps of her house back in November — and that she’s “not quite looking the same.”
“In addition to breaking my wrist, I somehow managed to injure my face as well,” she wrote. “I’ll spare you the gruesome details, but when I came out of surgery the night of my fall, the doctor told [Underwood’s husband] Mike that he had put between 40 and 50 stitches in.”
That might sound like a lot, but it’s actually tough to know how serious an injury is simply by the number of stitches it requires, says Daniel Y. Maman, MD, a board-certified plastic surgeon at 740 Park Plastic Surgery in New York City. “For example, if someone had a short laceration on the eyelid, it might require many extremely fine stitches, whereas a laceration of the same size on the underside of the chin might have two to three stitches,” he says. Plastic surgeons often close a wound in three different layers, adds Dr. Maman, which increases the total number of stitches used but may not mean it’s a more serious injury.
Dr. Maman, who did not treat Underwood, explains that physicians in emergency rooms and urgent care facilities are capable of taking care of facial injuries. But the results are often better when an experienced plastic surgeon repairs what he describes as a “cosmetically sensitive” wound. “There are a lot of things we can do in the long-term for scar optimization, but there’s no question that the best scarring results from the best repair in the short-term,” Dr. Maman says.
How bad a scar will ultimately be depends a lot on the nature of the injury itself. Certain areas of the face simply heal better than others, says Dr. Maman. The orientation of the laceration matters too. For example, a horizontal scar across a forehead blends in more than a vertical one, he adds.
The type of stitches — either dissolvable or those that must be removed by a doctor — can make a difference too. Says Dr. Maman: “In my opinion, the ones that need to be removed yield the best cosmetic results, so it’s worth coming back” to the doctor’s office for a follow-up visit. Stitches used in deeper layers of tissue are always the dissolvable kind, he adds.
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After the stitches are in, it’s important that patients are careful not to re-injure their face. A few weeks into recovery, they can begin to use silicone-based scar tapes or scar creams to help minimize the size of the scar, Dr. Maman says. Approximately a year after the injury, a scar reaches “full maturation,” he says. “At that point, I usually tell patients what you see is what you get.” If they’re not happy with the way the scar looks, cosmetic surgeons can use laser treatment or surgical scar revision to help alter the scar’s appearance.
Underwood, however, remains undeterred. “I am determined to make 2018 amazing and I want to share things with you along the way,” she wrote in her post. “And when I am ready to get in front of a camera, I want you all to understand why I might look a bit different.”