Asymmetrical Swelling After Arm Lift?

     If there is a significant size difference between the extremities and associated pain, an exam followed by an ultrasound may be necessary to evaluate for blood clot.  Kenneth Hughes, MD Los Angeles, CA

Thank you for your question regarding asymmetrical swelling after an arm lift. You mentioned you were three weeks out from your arm lift or brachioplasty. Therefore, you are still healing. It would be best if you waited at least eight weeks to evaluate the arms. Therefore, you have at least another 5-6 weeks to go. Wound openings can also delay final healing. The fact that you have swelling only three weeks after surgery is quite normal. If you have swelling around your wrists and even your fingers, you must have these areas compressed. I suggest compression from the wrist to the armpit 24 hours a day. This would either be with ace bandages or a compression sleeve. This will help to minimize the swelling and flatten the scar. It would be best if you were concerned but not overly concerned. Almost always, the swelling goes away and is not permanent. Please continue to consult with your chosen plastic surgeon. I hope this helps to answer your question regarding asymmetrical swelling after an arm lift.

It's not unusual for patients to develop swelling following brachioplasty. The swelling may occur for a variety of reasons, but is usually always transient in nature.Occasionally, patients develop localized unilateral swelling of the arm. When this occurs, other causes should be considered including seroma and hematoma formation. When these conditions occur, drainage is often indicated.For these reasons, it's important that you discuss this problem with your plastic surgeon so appropriate intervention can be undertaken if necessary. When this occurs, results are usually excellent, but failure to address these issues can result in complications including wound breakdown.

Asymmetrical swelling after an arm lift (brachioplasty) can occur and is generally not uncommon. There are several possible reasons for this:
1. Normal Postoperative Swelling: It’s typical for one side to heal at a different rate than the other. Variations in swelling, bruising, and discomfort between the arms are often part of the normal healing process.
2. Fluid Accumulation: Sometimes, fluid can accumulate under the skin (a seroma), causing swelling. This can happen unevenly.
3. Hematoma: A collection of blood outside the blood vessels (hematoma) can form, leading to asymmetrical swelling. This usually occurs within the first 24 hours after surgery but can happen later.
4. Infection: Although less common, an infection could cause localized swelling and should be monitored for signs like increased redness, warmth, pain, and possibly fever.
5. Lymphatic Issues: The lymphatic system can be disrupted during surgery, leading to temporary or persistent swelling in one arm more than the other.
If you notice significant asymmetry, increased pain, redness, or warmth, or if the swelling does not seem to be subsiding with time, it’s essential to contact your plastic surgeon for a thorough evaluation. They might need to check for complications such as infection, hematomas, or other issues.

Photos would help. If the wrist is really that much bigger I would be concerned about a possible blood clot in the arm veins.. Alert your surgeon who can decide if it needs to studied with an ultrasound exam. 

All the best. 

These maybe separate problems or related to each other.  The swelling maybe normal postoperative edema vs. clots or damaged to the deeper vein structure of the arm.  Deep venous clots impair the blood return from your hand which could cause swelling and also the pain in your forearm and could be life threatening if the clots break and travel to your heart and lung.  Conversely, the tenderness in your forearm could be the result of nerve injury.  In the path of dissection during an arm-lift there are a couple of nerves that are at risk.  Please revisit your concerns with your surgeon.