10 days post brachioplasty (arm lift). My armpit incision seems to have opened up. Please advice. I've already called my surgeon

Question

Hi, I am 10 days out post brachioplasty (I also had a breast lift w/ implants at the same time. I had my drains removed at my 1 week appointment but everything seems to have gone downhill from there. My arms are profusely leaking, mostly clear/bloody fluid to the point that I am soaking through layers of gauze, my compression, and clothing. My armpit incision seems to have opened up. I called my surgeon, they said to put Vaseline and cover with gauze but I am still very concerned. Please advise.

J. Timothy Katzen, MD, FACS · Answer

Hello, thank you for your question regarding what to do with your arm wound after your arm lift (brachioplasty), or more accurately, arm reduction.   I am sorry that you are having this complication.   After an arm lift or brachioplasty,  wound break-down is not uncommon in the axillary region.   This armpit wound breakdown can be due to a variety of reasons.   There are functional reasons why the arm wound opened.  Reasons include moving the upper arm too much ( especially upper arm abduction),  the post-operative resting position of the arm was too elevated, or the arm dressing were too tight. There also anatomic reasons why your arm lift  incision opened.   There are many lymphatic vessels and lymph nodes in the armpit.  Unfortunately,  lymphatic vessels are almost invisible.  During your brachioplasty, these lymphatic vessels may have been transected inadvertently.    It is almost impossible to perform a complete brachioplasty without transacting some lymphatic vessels.  Now, these transected lymphatic vessels may be leaking clear lymphatic fluid.   Also, in the armpit there are many hair follicles. Hair follicles harbor bacteria which can lead to localized infection.  It is extremely important that you follow up with your board-certified plastic surgeon. Each plastic surgeon has their own way of treating wounds.  This is not the forum to seek for wound treatment.   Fortunately, in my 20 year experience, all arm wounds heal over time with conservative care.   Thank you for your question regarding an arm lift or brachioplasty won’t break down. If you have anymore questions regarding the arm lift or brachioplasty, please contact my office. Sincerely, Dr.Katzen.  (Certified by the American Board of Plastic Surgery and member of the American Society of Plastic Surgery, American Cosmetic  Academy, and International Society of Aesthetic Plastic Surgery.)

Donovan Rosas, MD · Answer

Wound healing difficulties are not uncommon following brachioplasty. These are especially common in the axilla as this is a high tension high traction area. Most will resolve on their own with local wound care. Patience is paramount in these cases. 10 days is early in the healing process. Given time all should improve. As always, discuss your concerns with a board certified plastic surgeon (ABPS).Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic
Surgery, American Society of Plastic Surgeons
RealSelf Verified Member
RealSelf Top 100
RealSelf
Hall of Fame

Russell Bramhall, MBChB, FRCS(plast) · Answer

Hello,
The first thing to know is that your wounds don't look currently inflamed so you should be reassured that if you are feeling well any significant infection is unlikely.  Slightly yellow, but clear discharge is normal with wound opening.  Keep an eye out for any signs of more cloudy discharge though which can sometimes suggest infection.  Whilst wound opening is unusual and inconvenient, these almost always heal with time and the scars normally still settle very well in the long term.  It would be worth asking for an appointment to see the surgeon or nurses in your clinic who will be able to guide you regarding the best dressings to use to help minimise your discomfort and keep your clothes clean whilst they're healing.
Good luck with it all anyway and I wish you a speedy recovery.

Francis Johns, MD · Answer

Thank you for your question. This is very common in arm lift surgery. There is a significant amount of tension on the incision with the movement of the arm. I would follow the instructions from your surgeon, these incisions typically heal well despite this happening. Good luck with recovery.

Kenneth Hughes, MD · Answer

The incision at the axilla is very prone to separation as this is an area of tension and is subjected to additional tension during movement.  Recommend that you follow up with your PS to discuss the best options for treating your wound. It will heal; it will just take time.  I recommend protein shakes for optimal incision healing.
Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

Anthony Barabas, MBBS, FRCS (Plast) · Answer

The armpit area is the most likely area to have problems with healing due to movement here and difficultly dressing this area. An external skin stitch at this point may well help close it, so you should see your PS. However the fluid coming out may well not be pus, but rather serous fluid, or possibly even lymphatic fluid from the armpit.

David R. Alfonso, MD, FACS · Answer

the area you described can often have healing issues after surgery. If your symptoms do not improve you should be seen by your surgeon to ensure that everything is healing well

Daniel Barrett, MD · Answer

Dear Weightlosspatient,
it is hard to tell for sure but based on your photos, it does look like there in incision separation. This can occur after arm lift, especially in armpit area. It is best that you visit your plastic surgeon for further assessment. Only after thorough examination you can get proper recommendations and advice.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Mariam Awada, MD, FACS · Answer

Hi, thank you for you inquiry. I advise you to schedule an appointment with your plastic surgeon so they can take a closer look at it. It seems to have macerated. Maceration is defined as the softening and breaking down of skin resulting from prolonged exposure to moisture. I hope this helps, best of luck!

Deborah Sillins, MD · Answer

It is not uncommon for the incision line under your armpit to open up slightly. Follow your surgeon instructions and follow up in the office with your doctor.

10 days post brachioplasty (arm lift). My armpit incision seems to have opened up. Please advice. I've already called my surgeon

Answers (20)

More Arm Lift Questions

Arm lift scare -- will I ever be able to wear sleeveless shirts again?

I have one arm that's about 4 inches bigger than the other? What would be the best procedure for consideration for the arm?

Should I get arm surgery while I get a breast reduction at the same time or should I do a different procedure? (photo)

Is there anything I can do to help arm lift heal? It is red and slightly open. 6 weeks post op. (photos)

4 months post-op. My scar looks nice until halfway down and then starts widening. Why is that? Do I have a keloid? (photos)

Arm lift to correct botched Vaser liposuction to upper arms? (Photo)

WE SEND PRETTY
EMAILS