Revision for Bad Brachioplasty?

Question

Hello, I am a 45 yr old woman.  I have never been very heavy.  I have/had large arms since I was a little girl.  I have/had excess fat & slightly sagging skin on the upper part of my arms & would not wear sleeveless tops.  I went to 2 plastic surgeons seeking the limited incision barchioplasty.  Both professed to be able to do the proceedure, however, that was not the case...  I was left with no armpit, no/worse results & now have scars in addition. I am very depressed.I need help & refrence in CA 2 revise them. Please help

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding revising a lousy arm lift, arm reduction, or brachioplasty. I'm sorry you had suboptimal results; you were guided into a limited incision brachioplasty instead of the traditional full brachioplasty from the armpit to the elbow. It sounds like you can undergo a revision arm lift. This is not uncommon during your revision arm lift. Arm liposuction will be performed in addition to an incision from the armpit to the elbow. This should significantly reduce your arms. It is essential that you also be at a stable weight. Please consult with an experienced board-certified plastic surgeon who is comfortable performing arm lifts, arms reduction, or brachioplasty. Thank you for your question regarding revising a lousy arm lift, arm reduction, or brachioplasty. 
I specialize in arm lifts.  I hope that I have answered your questions regarding the arm reduction.  If you have any more questions regarding the arm lift, arm reduction, brachioplasty or arm crease fat grafting, please contact my office.  Since a brachioplasty or arm lift surgery is a difficult procedure, please seek an experienced, board certified plastic surgeon with significant experience performing these types of arm lifts. Do your research.  Make sure your chosen plastic surgeon has performed at least 100 arm lifts.  Make sure they have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Richard J. Bruneteau, MD · Answer

Although your history is helpful, it's virtually impossible to evaluate your result without pictures or a physical examination. In general terms, wound healing is a dynamic process which can last for 6 to 12 months. During this period of time, wounds remodel, swelling resolves and scars lose their redness and soften.For these reasons, it's important to maintain close contact with your plastic surgeon. If you're unhappy with your surgeon, it's appropriate to obtain a second opinion form a board certified plastic surgeon with experience in this area.

Scott C. Sattler, MD, FACS · Answer

Brachioplasty is not a technically difficult operation, but getting good quality brachioplasty scars is a challenge for any surgeon. For this reason, there is a fair amount of collective experience revising brachioplasty procedures. It may be that you had the 'wrong' operation for the arm problem that you had- a limited incision brachioplasty is not a great operation for most patients. Seek out a good plastic surgeon in your area for some expert advice.

Raffy Karamanoukian, MD, FACS · Answer

Scar revision for brachioplasty is an excellent choice and can be performed to reduce the scarring and deformity after your surgery.

Boris M. Ackerman, MD · Answer

Limited incision brachioplasty is designed for a very specific subset of patients.  You might not have been an ideal candidate for this procedure.  Furthermore, disappearing armpit can result from improper planning and performance of limited brachioplasty.  Good news is that almost always this type of sub-optimal outcome can be at least partially corrected with well planned and executed procedure. 

	I perform  many brachioplasties, both limited and full, and have revised a number of brachioplasties.  If you'd like, you may send to my office some photos and I'd gladly comment on your options for surgical correction

Andrew P. Trussler, MD · Answer

Limited incision brachioplasty is great for a minor amount of very high excess arm skin and when pushed to try to take the place of a full brachioplasty it can lead to wide scars, pulling of the armpit and poor contour to the arm. This could be easily converted to a full brachioplasty with scar rotation into the armpit with a z-plasty. You should consult with your board certified plastic surgeon to correct this and someone who does both techniques to correct it.

	I hope this helps.

	Dr. Trussler

Otto Joseph Placik, MD · Answer

I would agree with Dr. Rand's comments in regards to limited or minimal invasive management of massive weight loss outcomes. These are highly attractive options with less than ideal results. We all understand the desire for a short or minimal scar and if we had a wand that could achieve these results, we would use it. I would seek referrals from local bariatric surgeons or the American Society of Plastic Surgeons or Aesthetic Plastic Surgery.

Steven Turkeltaub, MD · Answer

Without pictures to better delineate your situation, it appears that you required a "standard" arm lift and instead got a limited incision approach which was not the appropriate option. Unfortunately as a consequence, the result is quite suboptimal.

	Scar revision and recontouring can be performed the outcome of which would depend on multiple factors including the extent of the deformity that you presently have. I would suggest that you contact a reputable board certified plastic surgeon in your area who has extensive experience in brachioplasties.

	Good luck!

Steven Wallach, MD · Answer

Revision brachioplasty sometimes can be offered but you have to wait at least 6 months or longer for the tissues and scars to heal and soften.

Samir Shureih, MD · Answer

Dr. Harlan Pollock have summerised advertising of cosmetic surgery very well.
He put his thoughts as follows:
PROMISES With a minimum of risk and little or no downtime, a variety of procedures, products, manipulations, etc. promise a dramatic improvement in ones appearance.
PITFALLS &bull; Generally the terms "non-invasive" and "minimally invasive" are designed more for marketing than therapeutic value. Certainly these are far more inviting terms than "surgery". &bull; High tech names suggest a new approach and an expectation of effectiveness. For example, if "laser"or "endoscope" is mentioned, cutting edge technology and superior results are implied. This may or may not be the truth but the patient may have difficulty separating hype from reality. &bull; Though these individual procedures may be inexpensive, multiple treatments are common and the cost adds up. Often the cost of multiple such procedures may be comparable to the cost of surgery. &bull; Many of these procedures may be effective in combination with surgery, but alone may be futile. The old adage "sounds too good be true" is important to remember when presented with a minimal procedure that produces wonderful results. Certainly a second opinion may be helpful to put things in perspective.

Revision for Bad Brachioplasty?

Answers (13)

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