What to Do with "Bunching" of the Skin After Arm Surgery? (photo)

Hard to tell from this picture but it does look like it is early in your healing process. Waiting a few more months and trying some scar therapy should help smooth things out

Thank you for your question regarding skin bunching after your arm surgery. It appears that you will need a revision. This could be a dog ear due to excess skin and fat in this localized area. This may need revision. Often revisions can be done under local anesthesia in the office. However, if the entire incision needs to be redone, this would probably have to be done in the operating room. Either way, I would go to a plastic surgeon specializing in arm lifts. Thank you for your question regarding skin bunching after your arm surgery.

Unfortunately, gathering of the wound margins can sometimes occur when patients have large amounts of skin removed during brachioplasty. This bunching occurs when surgeons intentionally avoid extending the incision beyond the axilla and elbow to avoid secondary complications.Although these scars can be very noticeable in the immediate post-operative period, they tend to improve with the passage of time. It's important to understand that wound healing is a dynamic process that continues for over 12 to 18 months following surgery. During this time, wounds remodel and scars soften and lose their redness.This process can be facilitated with a variety of maneuvers designed to avoid tension on the wound closure. Examples include steristrips, silicone sheeting and compression garments. Massage with a variety of topical agents has also been shown to be helpful. Rarely, if these steps are unsuccessful, secondary scar revision may be necessary.If you're concerned about scarring following brachioplasty, you should contact your plastic surgeon. Your surgeon should be able to formulate a treatment plan that addresses your concerns.

Hello and thanks for your post. If you're out from surgery less than a year, it might not be a good idea to do a revision on the scar at this point. You should talk to your PS about any other modalities to use on the skin before then. Best wishes, Dr. Aldo.

           It would be helpful to examine you and see preoperative photos.  At 6 weeks you will still have remodeling that will occur for another couple of months or so.  Find a plastic surgeon with ELITE credentials who performs hundreds of body contouring procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Without an in-person examination, it’s impossible to determine if anything abnormal has developed. You're still early in your recovery. We recommend consulting with your surgeon to further discuss your concerns.

Thank you for the question and pictures. Your concerns are understandable. The “band” that you demonstrate is a result of the arm lifting procedure. Because of the skin removed during the procedure there is tension in the area of banding when your arm is flexed. At this point, I would not suggest surgical intervention; I would agree with your plastic surgeon that ongoing time and possibly massage of the relatively tight area may be helpful.Best wishes.

I would take a wait and see approach to this issue. I would ask your surgeon about scar massage and the use of silicone gel sheeting. I would wait at least six months before considering a revision.

It looks like the longitudinal scar is starting to pull and may be pulling on the adjacent skin, which is folding.  It's like pulling up a balloon shade in how that folds with the scar being the rope of the shade.  If this is worse than the first few weeks, some aggressive scar massage to get some stretch of the scar to release this tethering.  If it is better than it was there is a good chance this will improve as it matures.  Your scar looks a bit wide and pink-red, so some BBL/IPL may decrease the redness and soften the scar by decreasing its circulation.  

I would talk to your PS about scar massage therapy as much of this well get better with time.  Best wishes.