Recent Brachioplasty - 2 Wks Post Op. Small 1' Opening Still Not Healing Quickly...

Question

I am doing saline packing on the small wound but is there anything else to speed the healing? Also why are the compression garments worn for 6 wks plus. Thanks in advance

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding a small opening after brachioplasty.
It is difficult to answer your question without pictures or a thorough physical examination.  Though not common, brachioplasty incisions can open.  The physical examination of the wound determines what topical treatments should be done.  If your arm wound is open, please visit your plastic surgeon weekly for treatment. 
Arm compression garments are essential after an arm lift or brachioplasty. The compression garments help to minimize swelling or edema. Though rare, permanent hand and forearm swelling can occur after a brachioplasty. Compression garments help to minimize this. The compression garment also helps to flatten the arm lift scar.   This leads to a better cosmetic result.
Good luck with your skinnier arms.  
If you have any questions, please do not hesitate to contact my office.  
Sincerely, Dr. Katzen

Richard J. Bruneteau, MD · Answer

It's not unusual for patients to have wound healing problems following arm lift surgery. The problem typically occurs where the vertical incision meets the transverse incision. This location is at risk for wound separation for a variety of reasons. These include poor blood supply to the skin flaps in this location and high levels of bacteria that occur in the axilla. Both of these factors can contribute significantly to wound breakdown in this area.Once breakdown has occurred, wounds tend to heal by secondary intention. Tissue tends to form a layer of granulation and wounds contract. The skin grows over the top of the granulation tissue. In the initial phases of healing, there may be an intense inflammatory response that can make the wound look red and angry.For these reasons, these wounds should be monitored closely. If infection appears, antibiotics should be started immediately. In the interim, local wound care should be continued with dressing changes. When this approach is taken, wounds tend to heal nicely. Rarely, scar revision may be necessary as a secondary procedure. If you have questions or concerns about how your wound is healing, it's important that you discuss them with your plastic surgeon. Your surgeon should be able to address your concerns and alleviate your anxiety.

Larry S. Nichter, MD, MS, FACS · Answer

Unfortunately the arm pit is a difficult area to heal because of frequent motion and high normal bacterial counts, sweating, etc. Arm lifts therefore occasionally have problems like this, especially in the axilla (arm pit).
	The most common reason would be absorbable sutures that are reactive and being pushed out  through the the skin but an infection could also be the cause.
	The good news is that your arm lift will heal. It just needs more time.
	See your board certified plastic surgeon to be checked.

Siamak Agha, MD, PhD, FACS · Answer

I know this must be a concern for you, but it is unfortunately very common post armlift for patients to have openings occur. You should first consult your surgeon with this issue and they will give you proper instructions on how to take care of your opening in order to properly heal your wound.

	When this occurs to my patients I will have them increase their protein levels and to make sure they are packing and doing dressing changes twice a day. Keeping the area clean is essential.

	If for any reason the scar does not turn out favorably, you can have your surgeon perform a scar revision or you can consult with another board certified plastic surgeon about your revision. Whichever you prefer if it happens to occur.

	I have included a link below that may be of interest to you. Best of luck.

Richard Dale Reynolds, MD · Answer

Unfortunately it is not too uncommon to have some small areas with delayed healing after a brachioplasty. The skin quality in this area is unique. It will take several weeks to heal but it will heal well. A scar revision may or may not be necessary depending upon the result at 6 months to one year.

Tom J. Pousti, MD · Answer

It is very normal to have small wound healing issues after surgery. Every patient heals at a different rate. Be patient. As for the garment, I use a compression garment if liposuction is performed for 4 weeks. If liposuction is not performed I tend to take off arm dressings after 2 weeks. Each surgeon has their own way of doing things - discuss your questions with your surgeon.

Vasdev Rai, MD · Answer

Patience is the key.  You are doing right things.  Juat give it more time.  It is not unusual for minor wound seperation to take 4-6 weeks to heal completely.

Darryl J. Blinski, MD · Answer

Very common to have minor wound separation in a brachioplasty. Good wound care will help resolve this. Six weeks is an average time we use, it could be 4 weeks to 8 weeks in a range.

Albert Dabbah, MD · Answer

Be patient.  Our bodies want to heal and it will.  It usually takes much longer than patients expect but for us it is normal.  It sound like you are getting appropriate care and if that is your only concern, it sounds like you are doing well. 

	Some surgeons use compression garments while others do not.  It is a preference for some but not all surgeons require it.

Joseph N. Togba, MD (retired) · Answer

It is not uncommon to have a small area(s) of wound separation after a brachioplasty - primarily because of prolonged swelling in the operative area and increased tension on the incision with any arm motion. Keeping the area of separation clean as you are doing will result in healing of the site in an additional two to three weeks.

Recent Brachioplasty - 2 Wks Post Op. Small 1' Opening Still Not Healing Quickly...

Answers (12)

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