When to Call a Plastic Surgeon
Signs Your Child or Adult Needs a Plastic Surgeon and Not the ER
Not every cut needs a plastic surgeon. But for certain wounds — particularly on the face, lip, and any cosmetically visible area — a plastic surgeon provides a meaningfully better outcome than an emergency room closure. The ER closes the wound to stop bleeding and prevent infection. Dr. Karamanoukian closes the wound to produce a scar that heals invisibly. Those two goals require different techniques, different suture materials, and different amounts of time. An ER sees twenty patients per hour. Dr. Karamanoukian sees one wound at a time.
Call (310) 998-5533 immediately if: you can see fatty tissue in the wound · bleeding does not stop after 10 to 15 minutes of pressure · the wound is on the face, lip, or eyelid · the wound edges are separated · the laceration is from an animal or dog bite · your child has a facial wound of any size. All facial lacerations should be repaired by a plastic surgeon on the initial injury.
Facial Lacerations
Any wound on the face, regardless of size, is best repaired by a plastic surgeon. Poor ER closures on the face produce railroad track scars, step-off irregularities, and vermilion border misalignment that are difficult to correct later and visible for life.
Pediatric Wounds
All lacerations in children are cosmetically sensitive. A scar repaired poorly at age 4 is carried for 80 years. Dr. Karamanoukian applies the same precision to every pediatric laceration as he would to an adult facial surgery case.
Lip and Vermilion
The vermilion border — the line between lip and skin — must be aligned within 1mm or the step-off is permanently visible. Always see a plastic surgeon first for any lip laceration, no matter how small it appears.
Dog Bites
Dog bites involve contamination, irregular wound edges, and tissue avulsion that require specialist reconstruction. Dr. Karamanoukian irrigates, debrides, and closes dog bites with the same layered approach used for clean lacerations — plus antibiotic coverage and post-bite scar management.
Post-Stitches Scar Treatment at Kare Plastic Surgery
The scar does not stop forming when the stitches come out. It continues to mature for up to a full year after the injury, which means the scar management protocol that begins at stitch removal is just as important as the quality of the initial closure. Dr. Karamanoukian initiates the Kare scar management protocol at the stitch removal visit and continues it through the full maturation period.
The Kare post-stitches scar management protocol: Day 1 after stitch removal — medical-grade silicone gel applied immediately to the closed wound. The silicone is worn continuously for 8 to 12 hours per day for 3 months to hydrate and flatten the forming scar. Week 4 to 6 — Vbeam 595nm pulsed dye laser targets the vascular network forming within the scar to prevent thickening and redness before it establishes. Month 3 to 12 — continued silicone and sun protection with monthly progress checks. The combination of early Vbeam with silicone tape produces significantly better scar outcomes than waiting to treat a scar after it has already formed.
"Every parent who brings their child to me for a facial laceration is scared. The first thing I do is make sure they can see that I am calm and that their child is in the right hands. Then I take all the time the repair requires. A lip commissure repair done correctly takes 45 minutes. Done in an ER in 10 minutes, it shows for a lifetime."
— Dr. Raffy Karamanoukian · Kare Plastic Surgery, Santa Monica
Authority Page · Kare Plastic Surgery & Skin Health Center Emergency Laceration Repair Los Angeles — The Authority Page at Kare →
Complete emergency laceration repair guide — facial lacerations, pediatric stitches, dog bites, layered closure technique, stitch removal timing, and post-repair scar management for adults and children in Los Angeles and Santa Monica by Dr. Raffy Karamanoukian.
Frequently Asked Questions
Where can I get emergency laceration repair in Los Angeles?
Kare Plastic Surgery at 804 7th Street in Santa Monica near Montana Avenue offers same-day emergency laceration repair for adults and children by UCLA-trained dual board-certified plastic surgeon Dr. Raffy Karamanoukian. Facial lacerations, lip laceration repair, pediatric stitches, stitch removal, and post-stitches scar treatment. Call (310) 998-5533. We serve patients from Santa Monica, Beverly Hills, Brentwood, Pacific Palisades, Malibu, and all of Los Angeles.
Is it better to go to a plastic surgeon or the ER for stitches?
For any laceration on a cosmetically sensitive area — especially the face, lip, nose, or eyelid — a plastic surgeon provides significantly better long-term results than an ER closure. Emergency rooms prioritize stopping bleeding and preventing infection. Plastic surgeons additionally use layered closure technique, finer suture material, and precise tissue handling that produces invisible rather than visible scars. The difference in scar outcome between a plastic surgery closure and an ER closure on the lip or face can be dramatic and is largely irreversible once the wound has healed. Call (310) 998-5533 before accepting an ER closure on your face or your child's face.
When are stitches removed after laceration repair?
Stitch removal timing depends on the anatomical location. Facial sutures including the lip, nose, eyelid, and cheek are removed at 4 to 5 days to prevent railroad track scars from forming. Forehead sutures come out at 5 to 7 days. Scalp sutures at 7 to 10 days. Body and extremity sutures at 10 to 14 days. Removing sutures on time is critical — leaving facial sutures in even 2 to 3 days too long allows the skin to grow into the suture material and creates permanent track marks on either side of the wound. Dr. Karamanoukian schedules stitch removal at the correct time for each patient's specific wound location. Call (310) 998-5533.
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