I've wanted this surgery since 2006 with Dr. Capella and I am finally realizing my dream. Dr. Capella's technique is to make one long incision from the elbow down the side of the flanks and under the breast resulting in a beautiful contour. He is very well known for his arm lifts, and has the largest experience in the world of this surgery. I invite you to follow my journey and see before and after photos here.
Arm Lift Complications after Major 6-hr Surgery (4 procedures) Dr. Joseph F. Capella Took Good Care of Me Throughout Recovery
I've wanted this surgery since 2006 with Dr....
Complications after brachioplasty
My photos also show the right arm in which there has been some minor skin necrosis (death of skin cells). This is the long white line that you see that runs along my incision and goes about 4-5 inches down the arm, as well as the circular wound. This is not a true necrosis in that the underlying skin is in good condition and only a small area of superficial skin cells are sloughing off. Google images of skin necrosis and you will see the difference. My surgeon said this condition was caused because he pulled the skin tight. Note that he did not say he pulled it too tight! That would be very bad!
Although my arm looks pretty awful, it is not as bad as it seems. There is a burning sensation on and off, and a sharpness if I extend my arms too far. I rate this as discomfort rather than pain.
Treatment is to keep the area dry with gauze, and my surgeon said I was welcome to try the Xeroform (gauze with pertroleum and 3% Bismuth Tribromophenate) that a few patients had recommended. I find the expensive Xerform to be soothing on my arms but it is too soon to tell if it will provide any other benefit. Like many products that are out there for pre and post plastic surgery recovery, it may just be a gimmick. I will let you know my opinion a little further down the road. Regardless, my surgeon told me that he hopes I will be recovered by 3 weeks, which will be 6-mos post op, and I can return to vigorous exercise. Yikes I hate feeling like a couch blob until then!!!
My surgeon said that I will have a thicker scar in this arm and he would revise it in his office when the time was right.
Some people have been overly concerned when they saw my photos. It does look a lot worse than it really is. I do not want to scare anyone considering brachioplasty, but rather prepare you for what might happen. These complications are more annoying than anything else. Of course I speak only of my own experience and with my specific surgeon who is a master in brachioplasty. Your personal experience based on your health conditions and your pain threshold and the skills and experience of your surgeon could be very different.
I read somewhere that the ASAPS says the avg plastic surgeon performs 1-2 arm lifts per year. I have not asked Dr. Capella how any he has performed but he has the most experience in the world doing this procedure. From what I see he is doing at least 1-2 of these per week, if not more. My estimation is that he has done more than 1000 arms, and I am probably under estimating that.
My point being is that I trust my surgeon's expertise and skills. And while the arm healing is a minor setback, I am not at all worried about the final outcome. He does fabulous arms and I am happy that he does pull them really tight. I have seen too many surgeons who under-correct the arm lift and the end result is mediocre. If I am going to have a scar along my arm, then I want the very best shaped arms I can get. Not something mediocre.
I have posted a before shot of my arm taken during markup. I will post an after shot at 3-mos and 6-mos post op. I also will post periodic shots of the arm healing.
My brachioplasty was performed as part of a nearly 6.5-hr surgery that included: body lift (no tummy tuck, which was done previously), inner thigh lift, monsplasty, and upper body lift (breasts, flanks, arms). My entire body has now undergone body contouring and you may read all about my journey here: http://www.realself.com/review/ramsey-nj-medial-thigh-lift-lbl-arm-lift-flankplasty-breast-lift-monsplasty#/
A final surgery is planned for 2014 to do my implants and face/neck lift, and any minor revisions and tweaks to my body. I will be sure to write a review on that experience when the time comes. Until then, I will be healing and returning to life as usual -- but with a smoking hot body, :-)
Right arm is healing
I will be 6-weeks post op in just about 2-weeks, and time cannot fly quick enough for me. Geez, I cannot believe it is almost Thanksgiving.
Arms and Axilla at 4 weeks 1 day post op
Dr. Capella asked me to do the wall crawl with my fingers to stretch my arms aboce my shoulders. My skin is so tight that I cannot lift my arms much above my shoulders at this point. Of course, the pain in the axilla don't help! Ouch!!!
But it is really the axilla that bother me the most and I just don't know why they are not healing. Not happy today...
As for the Xeroform pads, my surgeon advised me to stop using them a few weeks ago. He did not like the way that my arms looked and prefers the dry gauze treatment. Furthermore, he likes the rough weave gauze because it pulls out the debris. He told me that I would not be able to find the rough weave in the pharmacy, that everything is fine weave. So I have tried ordering the Covidien Gauze Sponges from Amazon in hopes that it will be the rough weave. The price on Amazon is much less than in the pharmacy. I ordered 200 4x4 for $7, free shipping. The Xeroform BTW was $55... in my case they were a big waste of money.
Dr. Capella assured me that my arms will heal. I asked him if the stretching exercises were contraindicated for the axilla healing (streching exercises are to lift my arms above my shoulders whereas axilla healing are NOT to lift arms above the shoulders). He told me that I could stop the stretching and the axilla will heal quicker, but reassured me that they will heal regardless. I chose to keep doing the exercises and let the axilla take longer to heal.
For me, not lifting my arms above my shoulders prohibits me from living life as usual. It was not good for my psyche to be unable to do hair and makeup, to have to keep wearing my same few recovery shirts that open and close in the front versus wearing my normal pretty shirts that must be pulled over my head. Additionally, the limited range of motion is what is most bothersome to me so I will prioritize this healing over the axilla.
As far as hyper granulation, Dr. Capella said he is not sure if I have it. Remember he is only able to see it in a one dimensional photo, not in person. To me it looks as though the wound on my right arm has hyper granulation but Dr. Capella said it doesn't normally occur there but rather in the axilla. So at this point I am not sure where he wants me to use the nitrate sticks. He is going to walk me through using them when they arrive next week. So I will find out then and let you know.
BTW - a word on panty liners
Arms at 37 days post op
Now these are awful looking arms...
Axilla after treatment with silver nitrate sticks
Late the next day my armpit wounds began to hurt, like they had been feeling a couple of weeks ago. I looked at them and all of the white/light grey tissue was read again, and there was a sizeable area of grey surrounding the wound. I wish that I could upload a pix but I took it on my phone and sent it to Dr. Capella. As luck would have it, this happened later in the day on Friday, just before 4:30pm, and I did not hear from him. I know he would have text me back by today if it was something to be concerned about. But just the same it would have been relieving to hear from him that everything is OK. Why do these things always happen to me on end of day Friday?!?!
My arms continue to be painful... tolerable, but painful. It has been a really long month from when they first opened until now. I am really glad the arm wound has shown such fast improvement once the foreign objects (the sutures) were rejected.
I want to reiterate that this is a minor complication and should not scare you off if you are considering having this surgery. It always looks worse on someone else than it is if you yourself go through it. I was so afraid of my arms opening up, but I figured they would. And when it happened it was not all that bad as I had imagined. It really is more frustrating than anything else.
Now that I am 6-weeks post op, Dr. Capella cleared me to exercise, except not repetitious lifting my arms above my head. So I worked my core and my calves today at the gym.
The right arm wound where the sutures came from (I think this is called spitting stitches, not sure) was already healed over with a thin coat of skin. Dr. Capella called it epithealized, which is the next phase of healing. Yeah!!!
Pix of axilla after treatment with silver nitrate sticks
It seems the silver nitrate sticks that I used on my axilla seemed to make them worse. Between that and the limited ROM I got scared this past Sunday and called Dr. Capella. Yes, I hated doing that but I was on the verge of an emotional crisis. He was understanding as always. He told me to stop using the silver nitrate and assured me that no patient of his has ever lost range of motion. He said that I do not have to do any treatments now because the wounds are nearly closed. I felt much better after that.
Axilla and arm wound at 7.5 weeks post op
My lovely arms 2-mos post brachioplasty
Arm wound healed at 8 weeks post op
How a surgeon manages a patient after surgery...
As for this surgery, Dr. Capella saw me every morning in the Care Center and even on weekends. He made sure that both he and I were completely sure that I could take care of myself on my own at the hotel before I left the care center. As for aftercare, he insisted on knowing the hotel I was staying at alone in NJ. He wanted a way to get in touch with me super-fast and said he or his office would call me if they had not heard from me for a few days.
My first night in the hotel he asked that I call him at any hour of the night if I were to have a complication. He had me specifically promise to call him if I had shortness of breath and he would have me admitted to a nearby hospital. Well, I did awake from a dream with labored breathing at 4am and called him. I told him I did not know if it was anxiety induced or something serious. He told me to have the front desk send the paramedic and they would be able to tell. Later that day after surgery, Dr. Capella called me to make sure I was OK. I was fine. It was just anxiety.
Other times before I left NJ I had fevers, groin pain, depression, and my axilla opened. He saw me immediately each time and treated me. He called in prescriptions and had them delivered to my hotel. At one point his PA Scott possibly saved my life because I was taking diuretics w/o doctor's orders and depleting my body of water and potassium. I was pretty ill and he picked up on it.
Once I developed the minor arm wound back home, Dr. Capella sent me for a CBC to make sure I did not have an infection. He monitored my healing via photos and emails and phone calls. He phoned me during his lunch time on a number of occasions, as well as answered my emails and calls across the weekend. And my arm wound healed pretty much right on schedule, just as he said it would.
How a surgeon manages a patient after surgery is a true testament to his/her character and dedication. Body contouring surgery is not a singular transaction, wherein once the surgery is completed the interaction can be considered to be done. Your surgeon will need to be responsive to your needs and concerns during the months of recovery that will follow.
I have said it many times, and it bears repeating: You are not buying a procedure. You are buying a plastic surgeon.
It looks to me like I will need some scar revision, just as Dr. Capella predicted. But they look pretty good all things considered and I am pleased with my recovery.
I like how narrow I have become
I truly enjoy looking at myself nude. How many women can say that? I surely could not say it before plastic surgery. Not since I was a teenager! I like that my arms and breasts look so youthful and slender.
It is really wonderful to love and appreciate your own body.
Right Arm Wound Healed Nicely
Follow-up appointment with Dr. Capella yesterday
Kerry, his new (and lovely) patient coordinator was extremely kind, going above and beyond to help me (and my dog) get from the Route 17 train station to my hotel. BTW Dr. Capella's practice is one building away from the Ramsey Route 17 train station making it extremely convenient to get to his practice.
When I arrived at Dr. Capella's practice that afternoon, Kimberly, who has known me from the start, came out from her office to greet me. Kimberly is the former patient coordinator and she was given a well-earned promotion to surgical coordinator. She was warm and friendly as always and very complimentary about my transformation.
Best of all was meeting with Dr. Capella. He had a smile from ear to ear and told me that my results exceeded his expectations. They exceeded my expectations, as well. I told him that I was so glad that I found him. Never would I have believed back in April of 2013 when my journey began that he could get me to a size 2 jean. As I have said many times before: You are not buying a procedure; you are buying a plastic surgeon.
I discused my arms with Dr. Capella. He believes that I will not need scar revision on either arm. Not even the right arm that had the ugly wound. He wants me to wait to see how they lighten. He is convinced that they will be the color of my skin. As he has never been wrong in any medical opinion he has given me, I easily trust his advice.
I did ask Dr. Capella to cut my right arm pit to remove some slight webbing that was there and was impeding my full range of motion with that arm. He said the skin would soften and stretch over time and I could forgo the z-plasty but I asked him to do it none-the-less. So he did.
It was fascinating to watch him do the procedure on me. I am his first plastic surgery patient that he did the procedure on, but he said he had done it a few times in med school. It did not take much time at all and I barely felt anything. Today the incision burns but that may have been aggravated by all the clothing changes I did. I did a photo shoot in NYC and had four changes of outfits. Of course, everything was over the head and required me to keep raising my arms.
I go back to see Dr. Capella tomorrow to plan my final surgery. I am very excited about that. It has been an amazing journey so far, and in some ways I am melancholy to see it come to an end.
Darn arm pit opened after z-plasty
It is not Dr. Capella's fault that it opened. I am sure it was lifting my arms over my head so many times on Tuesday to change clothes that disturbed it. He had told me not to lift my arm over my head. But everything I brought with me goes over my head.
Add to that, the morning that I left NJ to head to CA I had to take 2 trains, 1 bus, 2 cars, and 2 planes. It was the commute from hell and took about 15 hours door to door. The worst part was that there was an explosion that morning near Newark airport so my train would not drop off there. Instead, it dropped me off in Newark and told me to take a bus to the airport.
I lugged my 52 pound suitcase up stairs, down stairs, and all around before I finally found the darn bus. Needles to say my arm was opened even more the next day. The entire top of the z is open.
I am so glad that I will not be getting any revisions to my arm lift. I cannot take the healing. The only patients I know whose arms did not open were those who did not use them for anything for weeks. I do not think I could sit still that long.
*uck My Arms!
Add to that, my zplasty wound healed but since last weekend I can feel it tearing. I snapped a pic of it yesterday and I can see and feel two tears not in the incision but outside of it in healthy virgin skin. I just don't get it.
I am so frustrated with my brachioplasty. It is usually an easy procedure for people to recover from. Sorry for the whine. It is just me of those days!
Dr. Capella is perhaps THE leading plastic surgeon in the world for body contouring, especially after massive weight loss. He has restored my entire body, taking me from fat to fab. I was a size 14 pre op and now I am a size 2! I love love love my body and I adore Dr. Capella. I give my very highest recommendation of his work - he is one part surgeon, one part artist, and one part magician! LOL! As for my arm lift, my arms are now thin and lovely - no more bat wings! And when I had some minor complications a few weeks out from surgery, Dr. Capella was all over me, taking my calls and emails even during nights, weekends, and lunchtime. He kept me calm during what normally would be a very emotionally-charged experience. And owing to his sound treatment protocol, my arms healed very well. Dr. Capella is quite well known for his arm lifts, and has the largest experience in the world with this surgery. His technique is to make one long incision from the elbow down the side of the flanks and under the breast resulting in a very beautiful and youthful contour. I had the arm lift combined with several other procedures in one 6-hr surgery that included arm lift, flankplasty, breast lift, body lift (no tummy tuck), thigh lift, monsplasty, lipo. It is truly amazing how much he and his PA can accomplish in 6-hrs; most surgeons cannot do this! This results in the best aesthetic outcome and cost efficiencies. I invite you to read my full review and see more photos at http://www.realself.com/review/ramsey-nj-medial-thigh-lift-lbl-arm-lift-flankplasty-breast-lift-monsplasty