Serious Arm Lift Complications after Major 6-hr Surgery (4 procedures) with Dr. Joseph F. Capella, Ramsey NJ

I've wanted this surgery since 2006 with Dr....

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.

How thrilling that you are so close to your surgery date! Have you started gathering up your supplies yet, or is that on next week's to-do list?

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Well, I am now 3-weeks post op and on my to do list is: 1) heal, 2) return to vigorous exercise at 6-weeks post op. I need to fast forward through the next three weeks. I hate feeling like a couch blob.
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Arm wounds separated, skin necrosis aft brachioplast

Complications after brachioplasty

My photos above show skin dehiscence (the small wound opening in the arm pit - NOT the larger area of skin necrosis) after brachioplasty (arm lift), which happens in about 25% of patients who undergo this procedure.

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, :-)
Wow, that's wild!! You have such a healthy attitude about it, as scary as it may seem. That's a positive for someone like me. :). Thank you for sharing. :)
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You're welcome, Beth! Lots of people are asking me if he pulled me too tight. I do not think so. I imagine the wound would go deeper if that were the case. And despite how nasty the wound looks, the granulation underneath looks very healthy.
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I could have sworn my arms were done as tight as possible and now a new PS says I need a revision with lipo done to make my arms perfect, so I know yours aren't too tight...My PS does many arm surgeries also as while I was there in recovery there were 3 other arm surgeries done just in a couple of days. When I returned home after my surgery I turned on the morning news show and there was Kathy Lee and Hoda talking about how arm Plastic Surgery was up 800% in the last couple of years...ironic
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Right arm is healing

My right arm is healing and nearly all granulation tissue now. My surgeon told me to use only the dry gauze now and no tape. The openings in the axilla are bothersome and do not seem to be improving to me. Maybe it just needs more time owing to the stress of this area constantly moving. But my surgeon is checking new photos of the area to see if there is any hyper granulation.

Correction:

In my post on Nov 2, I wrote, "will be recovered by 3 weeks, which will be 6-mos post op, and I can return to vigorous exercise." It should have read, "will be recovered by 3 weeks, which will be 6-weeks post op, and I can return to vigorous exercise."

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

To me the arm looks as it is healing but the axilla look worse. I will ask my doctors.

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!!!

Arms and Axilla at 5 weeks post op

They do not seem to be improving to me.

Hyper granulation

I am so frustrated that my arms are not healing well. Here is a pic of the right arm with hyper granulation that has been there for at least a week. My surgeon is sending me nitrate sticks in the mail that he will instruct me how to use.

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...

Much better!

I pulled some of the debris off my right arm wound with my fingers. It looks much cleaner now, and healthier. Allow me to correct myself, in my post on Nov 14 I wrote, "I am so frustrated that my arms are not healing well." But what I meant was "I am so frustrated that my arms are healing so slowly." There is a distinction between poor wound healing, which is not what I have, and slow wound healing, which is what I do have.

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

You’ll need dressings under your arms to keep them dry. Initially, I used panty liners taped to my arms with surgical tape. This is a pretty common practice. Some people don't want to use gauze because it sticks, especially the rough kind that my surgeon uses. Initially my Dr. Capella questioned how absorbent panty liners were. Later when my axilla opened he told me to stop using them and use gauze, no tape, because the gauze was more absorbent. Also, the tape pulled some skin off my arms. Of all the things that I have tried, I do find that for me the rough weave dry gauze is most effective. It keeps my arms dry, whereas they are pretty juicy with everything else I have tried. What's more, it is a very low maintenance regimen to follow, and inexpensive. I really like to keep it simple and not get into all these complex and expensive wound dressings and regimens.

Arms at 37 days post op

My arms are looking better at 37 days post op, especially the wound that I removed the debris from.

Finally!

My right arm wound is looking better. The only thing that I did differently was to really pump up my protein intake, even more than the high protein I had been eating previously. I was afraid I'd gain weight eating all this extra food but instead I lost weight.

Also...

I also pulled two sutures from my arm wound in the past two days that apparently were working their way out. This may have contributed to the improved healing.

Now these are awful looking arms...

Here are the photos from me pre op photo shoot. Yikes, I did not know my bat wings were so large! Sometimes ignorance is bliss...

Axilla after treatment with silver nitrate sticks

I used the silver nitrate sticks on my axilla and it made the dehisced area turn a light grey/white. Dr. Capella told me to simply rub the stick on the wound and the silver would come off the stick and onto the wound. He said it would not burn. One armpit did not burn but the other did, although it was not what I would classify as painful but rather uncomfortable.

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

These pix show the skin turned white/grey in the axilla after treatment with the silver nitrate sticks. The pic also shows the epithealized right arm wound.
Gosh, I am having this done tomorrow! I didn't know the scar would be so huge! I am also getting a thigh lift at the same time....that's IF I turn up for it
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I had a thigh lift at the same time, too. I was petrified of having such a big surgery (upper and lower body lift and thigh lift) but I trusted my surgeon and I decided to do a larger surgery with him versus two smaller surgeries. I do not regret my decision despite this complication. Rest assured that my scar in my right arm is not typical so it probably won't happen to you. That said, I think that you are best going in fully informed that minor complications can happen even with the most brilliant surgeons and the most compliant patients. Complications are actually when he will know just how well you have chosen your surgeon. Everything is fine when surgery goes well, but if a complication arises, will your surgeon be there to take care of you in the long weeks/months of recovery ahead? Dr. Capella has always been there for me through this. My arm will continue to heal and he will revise it in his office. So in the end it's all good. Good luck for a safe surgery tomorrow!!! Try not to worry!
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Thanks for your kind words. I am 8 months out from having gastric sleeving, and I still have the dramas from that in my head. My surgeons office is 6 hours drive from the hospital where he is doing me, but I think I will be ok? He said it is more like a tighten up for me as I don't have a huge amount to take off. I have lost just under 40 kgs, and have been sitting stable at 57kgs for 3 months now. I had a lot of dramas with the sleeving, and still have trouble eating. Took me a good 4 months to even be back to my old self. I also have MS (the reason for the sleeve) but I thank you for your honest and frank words :)
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Nearly healed

My arms are doing much better! The axilla are about 1-cm big now. The arm wound is healed over and will continue to shrink. It healed at 6-weeks post op just as Dr. Capella said it would. It is too soon to tell if I will need scar revision, but I am certainly confident in Dr. Capella to do that if necessary.

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.
well, this morning I could stand it no longer, I was in so much pain and have not slept since 3 am tues morning (except for 4 hours total) tired and cranky, I took suit off and holy crap! The bruising! I should have taken photos but I never. Just washed my hair and stood under the cool water and bathed. Managed to get the body suit back on after drying off and other half had to do the work of getting it on, buckled and zippered up. Al stitching is internal, and have not removed the tape to see how far it goes, but hell, even my fanny is black! My arms look so tiny tho even tho they are swollen! My thighs are very swollen and black so I cant tell much there. He removed500 mls of fat and fluid and 2 kgs of skin...he said I didn't have a lot of fat at all, and he is going to email me photos of surgery. Cant wait to get my tummy done or my boobies, even tho this has been so painful, its worth it!
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Wow, I had hardly no bruising at all. I assume surgical technique and patient body composition and nutrition have something to do with this. I took a lot of supplements including arnica and Bromeline. Those compression garments and tape sound so cumbersome. I hope that you get comfortable soon. It sounds awful. Be well and I hope you can sleep tonight.
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My son is going to come baby sit me, he just rang. My partner just got on a plane to Brisbane as his dad has been having radiation treatment for jaw cancer, and they told him last night he had 2 days to live and he rang the other half and said please come. He didn't want to go and leave me alone as we live rural but I said I would be ok....his family wouldn't go to be with their dad, so it was left for him to do, he was very torn. That's why my son called and said he will baby sit me...so I will have a wine and not feel like I am scared lol I don't sleep when on my own, so maybe tonight I will:) Its the lipo that caused the bruising I think too. My legs and arms look A W E S O M E too even tho they are swollen, and my lips where he didlip filler and the botox has taken 15 years off my43 year old face! Woot Woot!
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Axilla and arm wound at 7.5 weeks post op

The left axilla healing is not as good as the right axilla because here I had used two silver nitrate sticks versus one on the right before my surgeon told me to discontinue use. The right arm wound is very small now.
Wow, that looks so much better already!! Nice!!
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Looking back, it does not seem to have taken long to heal. But while I was going through it, it seemed to take long at times.
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I want to thank you so much for posting this. I go to have surgery on Tuesday. And seeing these complications actually made me more comfortable.
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My lovely arms 2-mos post brachioplasty

Just wanted to post a pic of what my arms look like at 2-mos post op. I think they look lovely the way that they are, but in fact they will get even better as they are still swollen. I'll be sure to post a pic at 3-mos post op.
Is what you experienced typical? I wear strap t shirts in the summer, and although I have hanging blubber and wrinkly arms, I am petrified at the scar. Your arms didn't look that bad prior to this....I just wish you the best!
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Not at all typical... And if I did not do my arms there would have been a mismatch with there st of my body. My arm is completely healed now at 8 weeks and so are the axilla. The scar does not look bad at all, you would be surprised at how amazing the body is at healing.
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Wow...that's good to hear. Keep healing and keep us in check!
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Arm wound healed at 8 weeks post op

Fabulous! I am so glad to hear your good news jinxy6!
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Thank you!!!
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Of course I'm not out of the woods yet. I have Necrotic skin peeling on my back but it's getting better each day. My arms still have glue on the incisions. Did you do your bra line too? That's where my issue is.
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How a surgeon manages a patient after surgery...

They say a picture is worth a thousand words but what the pictures don’t show is my relationship with Dr. Capella. I had a few minor complications with my arms after this surgery and Dr. Capella was all over me -- just like he was all over me after my tummy tuck. The TT was my first surgery and I was scared. There was never anything wrong with me but Dr. Capella carried me through it until I was satisfied that I was OK (it was just normal swelling and nothing more).

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.
Do you have Facebook? Are you in any groups there? I get more support here but I find it easier to use. I wanted to IM my progress pics to you
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Why not post a review with photos? Then everyone can benefit from your experience. That is the beauty of social media, patients helping patients.
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I did but it took forever to be published! It's there now
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Scars

I have not posted pix of my arms in a while. I am approaching 3-mos post op, about 12 days away now - wow, time has flown! So decided it was time for some progress photos of my arm wound healing. I actually have not looked at them in weeks.

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.
Hi sweetie! I just wanted to check in on you. I'm doing well. I only have one more debreding left. Then on to scar revision. Yaaaaaay! I do have one "knot" like object under on arm incision line, but I'm told to keep massaging it. I did that with the other knotty spots but this one won't budge. Have u had that? You can't see it. You'd have to do it. It's weird. Anyway, chat soon!
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I am glad that you are doing well! The debridement sounds painful. I am glad it is almost over for you. As for what you describe as a knot, is it scar tissue? I have this on the sides of my face and under my chin from the facelift. My facial plastic surgeon's nurse told me to massage it and gave me a handheld massager that broke after two uses. Luckily I had my own little handheld "massager" and it is powerful with different settings and different heads. It seems to work well under the chin softening it up but the sides of the face seem more challenging. I think that I will make an appointment to see Dr. Winslow for a follow-up.
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I like how narrow I have become

With the arm lift removing the excess skin and fat that caused my arms to bow out from my body rather than lay flat at my sides, I now so enjoy looking at how narrow my upper body looks. I always thought I was broad across the shoulders but I am not. In fact most of my tops are size XS now.

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

I am 4-mos post op and amazed by how well my arm wound healed. It was quite the hideous sight for a while there. I believe that I will still need scar revision, actually I believe I will need scar revision on most of my incisions because I scar darkly owing to my part Latina heritage.
Look at my post OP from almost 4 year breasts, and 8 year tummy tuck....
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You look fabulous! I sure had better keep my act together and maintain these results for the long term!!!
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Next year at this time the scars will be a faded memory!
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Follow-up appointment with Dr. Capella yesterday

I arrived in NJ on Monday morning and met with Dr. Capella that afternoon. It has been 5-mos since I have been to his practice. He made some staffing changes and I found the atmosphere was warm and welcoming -- a true reflection of Capella Plastic Surgery.

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

Three days after my z-plasty, my darn incision opened. Dang! Now it will take weeks to close. By now I have become so acclimated to plastic surgery recovery that I am hardly phased by it. I've become one high-toned sonofabitch (as Stephen King might say), LOL.

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.
After your first surgery, when did your arms start to look like like that, I mean when you knew you had a problem. My Steri-Strips are coming off and I'm starting to get wigged out because I can see the scar now. I think everything looks okay so far except my left arm scar is flat and my right is "ropey"....bulgy. Also, did you have pain and tightness down the inside of your forearm when your arms were straight? I am trying to figure out if that is normal too.
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15 days after surgery... It was my first day home from NJ and I was 700 miles away from Dr. Capella. The corded feeling and tightness have not gone away for me yet, although that has improved. I do not recall of I had pain in the forearm because my darn armpits hurt so much and my attention was focused on that. I think people underestimate an arm lift recovery. It was the hardest part of my stage 2 surgery. It may take a long time for you to feel normal.
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I just read something that I wrote about my arms and I did have pain in the forearms when I extended them.
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Nice Arms! 5-mos post brachioplasty with Dr. Joseph F. Capella

I love my arms!
Perfect. Took a little longer than usual but great looking. Ive done my tummy, face neck and next arms and breasts. After losing 200lbs theres nothing else to do. Congrats! Your a hottie now girl!
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Smokin'!!
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Thanks, Beth!
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*uck My Arms!

I cannot believe it. My arm wound healing problems never end. I hope to never do surgery on my arms again. I had a small and simple procedure on my left arm when I was in Dr. Capella's office last month. He extended the incision to get rid of a "pop eye arm" that I had with my elbow tissue being too large. It wasn't a lot, but it was clearly visible. Anyway, five weeks after the procedure it just now opened today. I should be well outside the danger zone even for a brachioplasty opening, and yet this simple little incision is not healing well.

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!
Forgive me it is explained in the review but what is a z plasty? another silly question, you obviously know your stuff about skin structure, do you know of any reason why the arms should be the ones that produced necrosis? I am wondering if you are correct and a six hour surgery was too long or if this is just a complication that some people get. No disrespect to your surgeon, he's an artist and you seem to be his new muse.
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His muse, cute, LOL. Six hours is not too long of a surgery and not uncommon in plastic surgery. After 6-hrs the risks associated with general anesthesia increase, as far as I know. I was petrified none the less because I have a fear of anesthesia and I was convinced I was going to die in surgery. Plus I was going through PTSD. Moving on... A zplasty is an incision made in the shape of a z. There also is a wplasty. In my particular case, Dr. Capella said my arm opened possibly because of how tight he pulled me (although the other arm was pulled as tight and did not open) and that maybe the spitting stitches were a factor. I never asked him specifically about the sloughing skin cells but this is generally caused by a lack of blood supply to the area, as far as I know. I hope this helps. Before I wrote my formal article about my arm lift complications on HealthCentral, I discussed the matter with Dr. Capella out of respect to our relationship. He encouraged me to write about it because he said people should be aware that complications can happen. Indeed, even with the most brilliant surgeon and compliant patient "shit happens."
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Healing Issues with Arms

Well, my zplasty healed over since my last post but it again has a small tear. I just don't know why I have healing issues with my arms because the rest of my body that has been incised for my plastic surgery has healed just fine.

This new tear is a re-opening of one of the tears I wrote of in my last post. It happened after a shopping spree that I went on. I tried on a lot of clothes, many of which went over my head. So I assume that this motion had something to do with it. But I am just at my wits end as to why I have delayed healing, and only with my arms. I eat very healthy and take a lot of supplements. It is confounding.

I have a phone consult on Friday and will ask Dr. Capella about alternate treatments. My guess is that we will try silver nitrate and that I am just going to have to limit use of my arms for a longer recovery than what most people have to go through.

Again, for those of you reading, rest assured that my experience is atypical for a brachioplasty - with Dr. Capella or anyone else. Many patients have an easy recovery of it. Conversely, my thigh lift recovery was easy and this is a surgery that many patients have a very difficult time with owing to pain. I did not experience that. We each heal differently.

If I had it to do over, I would still get the brachioplasty even knowing what my recovery would be like. My arms look beautiful aside from the scars, which hopefully will lighten to my skin color. As for now, they are my darkest scars.

Arm lift incisions at 7-mos post op

I had arm lift 5 weeks ago incisions healing great , but I notice the incisions are really tender to the touch and they feel sore still. It's hard to lay on my side and prop up on my elbows. How long does it take till your arms feel normal tenderness goes away?
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Gosh, it is hard for me to recall... I would say mine took at least two months, and I still have hypertrophic scars and scar tissue at 7-mos out. Good luck! I will look at your review, if you have one posted.
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My Bariatric Life before and after plastic surgery with Joseph F. Capella MD - yes this really is me!

I received a lovely message from a WLS patient thanking me for inspiring her. She told me that she realize that she could do this and was not a complete failure.

We have the strength within us that it takes to succeed. We just have to find it. It took a long time for me to grow up and take on the challenge of my obesity. I have been free of obesity and my obesity related illnesses for more than a decade. The plastic surgery was the completion of erasing the sins of my past, getting rid of the telltale skin that was a constant reminder that I was a failure with regard to respecting my body for so long.

Not only did it shame me to look at my naked body in the mirror, but also it kept me from fully being present to living a life I love. I am so stinking happy nowadays. And I take such good care of my body, working out several times a week and eating super healthy. I know that I can fall back into old patterns of behavior so easily and ruin all the wonderful things I have achieved. I never want to backslide.

Just a little more than a year ago, the "before" photo above was taken at Easter. Yes, hard to believe that the person in both images is one and the same. The "after" photo was taken this past March, just 5-mos after my stage 2 body contouring with Dr. Capella and 3-mos after my facial plastics with Dr. Winslow.

I now have the body that weight loss surgery could not give me. It has been decades since I looked this good. As of this writing, I have lost 50-inches and 40-pounds. I went from a size 14 jeans being tight to size 2 jeans in less than a year since my tummy tuck (my first plastic surgery). Never did I imagine that a simple tummy tuck would lead to this.

I feel like I hit the lottery!
Just checking in on you and wondering how your right arm is doing. I'm so apprehensive about arm lift surgery. Would you do it again after all you are going through? I do hope whatever treatment you are getting is helpful. Best wishes.
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Thanks for checking in. Right now my answer to you is no. Hopefully when all is said and done I will change my answer to yes.
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Ladies, I have had an armlift. I am 4 months out. It is not perfect. I could probably use a revision. However, it is so much better than I have lived with for decades, and I WILL wear sleeveless, something I have not done since I was 25. Expect imperfection, but expect improvement. I am happy.
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Occupational therapy and physical therapy

Well, I have not posted an update in a while. I have been having continued problems with my right arm's limited range of motion. This all began when I awoke from surgery to find webbing in my armpit (some clinicians call it banding). So it made it tight and I could not move my arm the full range of motion. While I was in the Care Center, Dr. Capella had told me to stretch the arm, specifically to do the wall crawl, and the tissue would stretch. My PCP told me the same thing. So I was not worried.

Dr. Capella cleared me to go back to the gym after 4 weeks. There, my trainer gave me some very good exercises to stretch the arm. I was making improvement when rather suddenly the range of motion got worse instead of better. And it was very painful to move my arm past a certain point. I had great difficulty putting on my coat this winter.

Fast forward to March and Dr. Capella did a zplasty to lengthen the scar. It certainly did release some of the webbing, but not all of it. Dr. Capella's P.A. Scott said maybe I would need another zplasty. Unfortunately what happened is the zplasty opened 3-days after I had the procedure done. Scott advised me not to do any upper body exercises. It took the zplasty about 2 months to heal so that means I did not do any upper body exercises (including stretching the arm) for two months. This helped the zplasty to heal but at the end of two months I had even less range of motion and more pain in my arm. I could not hook or unhook my bra at this point.

So I had been in contact with Dr. Capella all along and he advised me to see a physical therapist, an orthopedist, a physiatrist. Subsequently I saw my PCP (who has a background in sports medicine), then an orthopedic P.A. and an orthopedic surgeon, who then ordered an xray and occupational therapy 3x a week and referred me to the practice's "shoulder specialist" for follow-up.

I have been in occupational therapy for a while and wow it was extremely painful at first. Psychologically it was very hard, too, because I have not had normal use of my arm for 9-mos and I feared how much longer it would take before I would, or if I ever would. But my doctor friends urged me to do the therapy. It was bad in the beginning. The therapist had a bunch of stretching exercises for me to do 2x a day every day. I would feel like throwing up and get lightheaded from the pain. But it is not as bad now. I recently saw the "shoulder specialist" and he ordered ASTYM physical therapy 2x a week and prescribed a cream to be applied 3x daily.

I posted a question about my arms to plastic surgeons on Realself to ask how they would fix my arm, because the webbing or banding is still an issue. When I saw Dr. Capella in June he said he would cut out the arm scar but not go into the axilla because that area tends to open (both of mine did). He said we have to wait for the tissues to heal before he can do that because my tissue is too degraded right now. The RealSelf plastic surgeons suggested a larger zplasty and skin grafting. I cannot tell you how much that frightens me. Not only do I NOT have insurance that will cover all of these expenses (and I imagine that skin grafting is extremely expensive) but also the physical and emotional trauma of going through a skin grafting and the toll it will take on my marriage -- if it comes down to that, and I surely hope it doesn't.

I began the physical therapy today in addition to the occupational therapy. I still cannot fasten and unfasten my own bra. I hate to sound like Debbie Downer but at this point I have to say this procedure was not worth it.

Any encouragement and positive advice is much appreciated right now.
Thinking of you and praying you get some answers and treatment. Your review/results have caused me to pause on this procedure. Of course, any procedure has a risk but it seems a higher percentage rate with brachioplasty. I'm so glad there are some professional women on RS to help.
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Thank you for your concern. I truly appreciate your checking in again. I honestly do not know which of these procedures has the highest rate of complications but my guess would be the body lift... just a guess. I have hope that at the end of my recovery, despite all that I am going through, that I will say my arm lift was worth it. It's just that right now going through it, it sure doesn't feel that way.
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You are a strong determined woman and I have faith in you that this too shall pass, and in a few months you are going to look back and say "wow I finally made it" . I know from reading many posts that brachioplasty is one of the most challenging. When i asked my doctor here in San Miguel if he would do it..he refused. I suppose for right now I am 'on the fence' and may or may not do it in the future. You are still young enough to where things heal more easily...so stay determined and strong.. You look amazing!!!! :) xx
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Just breathe...

I greatly appreciate my friends for stepping in and offering positive support and great advice. I am in a more positive frame of mind now. I hate the feeling of being overwhelmed by this and am keeping it at bay now. I want to feel empowered not helpless.

So I look at the people in physical therapy and I see how very ill or broken down some people are. And although it saddens me that these people are suffering, it also minimizes my injury, helping me to see that I could be much worse off. And I was quite happy the other day in PT that I was able to unhook and hook my bra!

I just need to remember who I am. I am strong. I do not give into fear. I overcome obstacles. I have a good life.

Now just breathe... And be with what is.
How are your arms doing..i had my arm tuck done 3weeks this wed and the arm pit wound is achy and of course open..im so frustrated with this..
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I am no longer in PT/OT and the shoulder specialist said he has done all that he can for me. I still do not have full range of motion at this point. Those armpit openings burn and smell bad (yuck) but eventually will heal. How are you now?
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Hope all is well. Have a Happy Labor Day!
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Dr. Joseph F. Capella

5 out of 5 stars Overall rating
4 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
3 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
1 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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