Stitches are done the same way as regular sewing is with needle & thread, which can be either thick black silk or very fine nylon thread, depending on whether the skin needs support or moves (thick) or is on the delicate facial skin. Stitches also can be done with metal staples just like a regular desk stapler. Both types are sterile & it depends on what procedure is being done. The skin is just like a piece of cloth & the edges of skin are placed together to match then sewn in place. Usually the doctor will inject novocaine or xylocaine to numb the area so you won't feel much pain.
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Either by needle and catgut or other suture materials or by use of preloaded staples.
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with needles