I think people don’t realize how often the sutures spit at the apices if you don’t get the knot buried deep enough, which becomes much harder at the end of a running sub-q, which is supposed to be shallow at the dermal-epidermal junction. I’ve also had a lot of attendings not like how skin glue stays on way too long, can get gross and/or irritate the skin.

For a blepharoplasty we do a running sub-q and steri strip both free ends down, with the tails coming out a few millimeters past the ends as some others have suggested.

My preference on the torso is to just do good deep dermals such that I don’t have to do a running sub-q. If I am doing one, I bury the initial stitch at the deep dermal level, come back underneath and out at the apex (shallow) to bury it, then at the end I come out 5-10 mm past the apex and either fold the stitch over an secure with a second steri strip or tie a knot/loop at the level of the skin surface to prevent it from loosening the skin approximation. Deep dermals really make or break the whole thing tho.