I Had a Bilateral Extensive Brachioplasty 5 Weeks Ago and My Arms are Uneven, What Are My Options? (photo)

I had a bilateral extensive brachioplasty 5 weeks ago. I have always had big arms, even as a child. I have lost 110 lbs on my own over the past 2 years and have been looking forward to the day I could wear short sleeves/sleevless shirts. But, one of my arms is bigger and as each week goes by my arm is starting to sag more and more underneath like it did before. I just wanna cry and my physcian doesn't think theres an issue. He said I need to workout but that didn't help before. Is there anything I can do?

Doctor Answers 6

Swelling can persist for a long time after upper arm surgery

This swelling can be frustrating.  The upper arms and calves can remain swollen much longer than other areas after surgery.  I would recommend that you continue with your compression carments, manual lymphatic drainage, arm elevation and scar therapy.  Time will usually allow the swelling and the asymmetry to even out.  In my patients, if they have very thick arms, I do SmartLipo or ultrasonic liposuction 3 to 4 months before the brachioplasty to get maximal arm reduction and optimal post operative scars.  If there is any residual asymmetry after all your swelling settles, your surgeon may discuss a slight reduction in volume by using SmartLipo.  It provides great fat reduction and promotes skin tightening.  Be patieint, upper arms can take a great deal of time to fully settle.  Dr. Scott Barr

Sudbury Plastic Surgeon
4.8 out of 5 stars 39 reviews

Asymmetry of Arms after Brachioplasty

Thank you for your question and pictures.

You are still early in the recovery phase of this surgery.  Brachioplasty surgery can be associated with swelling of the area for months after surgery.  Since it has only been 5 weeks since your surgery, I would suggest keeping your follow up appointments with your doctor and allowing your body to heal before deciding that a revision surgery needs to be performed.

Be patient.  

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Brachioplasty asymmetry

In the upper arm, swelling may take longer to resolve.  The use of compression garments is frequently necessary for at least 8-12 weeks.  Asymmetry is not that uncommon after bilateral procedures such as these.  The question is if the asymmetry is that conspicuous.  I would wait another month and continue to see your surgeon.

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 49 reviews

Residual Arm Sag Following Brachioplasty

It's not unusual for patients who undergo arm lift surgery to be concerned about the appearance of their arms in the immediate post-operative period. It's virtually impossible to make aesthetic judgments regarding the size and shape of the arms when patients are only five weeks post-op.

During this period of time, swelling, inflammation and the wound healing process itself all contribute to changes in the appearance of the arms. In most cases, it takes about 3 to 6 months before an assessment can be made about the aesthetic result.

At this point in time, your pictures suggest residual asymmetry and residual sag. Many of these findings will improve with the passage of time. It's, therefore, important to wait at least six months before considering revisional surgery.

For these reasons, patients need to be patient and maintain good communication with their plastic surgeon. Their surgeon should be able to reassure them and alleviate their anxiety.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Uneven arms following brachioplasty.

Thanks for your question.  I know how frustrating it can be following this type of surgery.  You have lost an incredible amount of weight and now have had surgery to give you thinner arms so you can wear clothing that you haven't been able to wear in a long time.  My best advice now is to still give things more time.  I know 5 weeks seems like a long time but you are still swollen based on your photos.  The majority of the swelling is gone but things will continue to change and improve over the next few months.  Even if there is significant unevenness at this point nothing should be done surgical to address this, its too early and unsafe.  You need to give things more time to heal.  The soonest I would start being critical is at 3 months.  Even then things can change.  If things are still unacceptable sometimes a small scar revision or liposuction procedure can be done to make things closer.  Don't give up hope yet.  Give things more time to heal.

Shaun Parson, MD
Phoenix Plastic Surgeon
4.8 out of 5 stars 46 reviews

Recovery after brachioplasty

Recovery after body contouring surgery takes some time, typically 6 months for most of the swelling to resolve and over a year for the scars to mature. Brachioplasty is no exception. Some asymmetry is common in the early recovery as postoperative swelling is often asymmetrical. At 1 month after brachioplasty, you are still very early in your recovery. If liposuction was used to help contour your arms, then you will typically experience even more swelling and this will also take time to resolve. Don't judge the result too early as it will change. Also, be sure to follow-up with your surgeon as scheduled and follow the postoperative instructions.

Jamil Ahmad, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 28 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.