Surgeon’s Cuffs

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Prior to the influx of tailors over a century ago, Savile Row was filthy with surgeons. When tailors started to move in, they accommodated their local clientele by making jackets with functional sleeve buttons that could be unfastened and rolled back, enabling a surgeon to work on a patient without removing his jacket. Hence, surgeon’s cuffs.

Obviously, it would take much less time to simply remove a modern day jacket, making surgeon’s cuffs as ornamental as fake ones. But they’re such a fun detail. Most jackets today come with four sleeve buttons, some come with three (or less if a designer is playing a trendy card). On my own jackets, I often leave the last one unfastened as a subtle flourish or to make room for a bulky cuff link.


Nowadays, bespoke or custom tailors offer surgeon’s cuffs as a standard option. Most off-the-peg offerings do not, usually sewing the buttons onto fake “stitched” button holes that don’t open. (Though Suitsupply‘s off-the-peg suits have functional sleeve buttons.) J.Crew does even less on their jacket sleeves, forgoing the fake stitched button holes, which enables a tailor to detach the buttons and alter sleeve length easily. Once the sleeve is altered, a good tailor can even make the buttons functional if one wishes.

As I said, surgeon’s cuffs are technically just as cosmetic as non-functional buttons. They’re almost purely decorative, like ties, pocket squares, lapel pins or even tie bars. But they provide a subtle accent and detail to a jacket that I absolutely love.


  1. George,

    Thanks for another great post. I’ve stumbled upon some men’s style forums that consider unbuttoning the last sleeve button as ostentatious. But like you say, surgeon’s cuff are cosmetic and pretty much decorative, and I completely agree. And I think because they’re purely decorative, I believe you have every right to do whatever you want with them.

    Thoughts on that?

    • George Reply

      Thanks, Lawrence. I’d like to see photos of the guys who consider it ostentatious to leaving the last sleeve button unfastened. But alas, we all need to create content and perhaps contrarian points of view with it. (Guilty myself.) But in light of other flourishes one could employ (lapel pins, tie bars, loud pocket squares, “fun” socks, colored laces, shrunken sausage-casing tailoring…) an unbuttoned sleeve button is an understated understatement that rides quite low on the radar.

  2. Very Cool! I have not encountered those yet, but as I move closer to getting some custom suits made, I will see if that is an option. Thanks so much!

  3. As someone with short arms I hate functional buttons for the reason they make altering a jacket sleeve either impossible or very expensive. The tailor has to detach the sleeve and shorten it from the top and depending on how the sleeve was constructed in the first place may not even be possible without having to perform major surgery (pun intended!). With current machine technology, presumably, even cheap fast fashion clothing companies churn out jackets with surgeon sleeves, H&M being an example.

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