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.