What can I do about arm lift scars? I'm a year post op. (photos)

Question

It is now a little over a year since I underwent an arm lift. The scars widened a few weeks after surgery and have remained red. Do the scars appear normal? Are they hypertrophic or keloid? Will they turn white? What is my best option at this point?

J. Timothy Katzen, MD, FACS · Answer

Hello,
Thank you for reaching out with your concerns about the scars from your arm lift, arm reduction, or brachioplasty. After reviewing your history and pictures, it's essential to determine the nature of your scars. If they are raised, bumpy, and extend beyond the original wound boundaries, they are likely keloids. If they don't exceed the scar limits, they are probably hypertrophic scars. While keloids and hypertrophic scars differ slightly in their nature, the treatment for both is quite similar.
There are various treatment options for both keloids and hypertrophic scars. These include injections of prednisone or 5-fluorouracil (5FU), microneedling, dermabrasion, laser treatments, radiation, and surgical excision. Since you are one year post-surgery, most plastic surgeons would suggest either fractional laser treatment or surgical excision as the most appropriate options.
Fractional laser treatment works by disrupting the scar tissue and facilitating the formation of new, healthier skin. This process may require multiple sessions, typically around five or six, to achieve the desired results. On the other hand, surgical resection of the scar provides a more definitive solution. Both arms can be treated simultaneously or in stages. During the resection, the scarred area is numbed with local anesthesia, and the scar tissue is surgically removed. Given your history of scars widening, the use of permanent sutures might be recommended to ensure better healing. This procedure can be performed under either local or general anesthesia, depending on your preference.
I hope this answers your question about managing hypertrophic or keloid scars following an arm lift, arm reduction, or brachioplasty. Wishing you the best of luck with your treatment.
Sincerely,
Dr. Katzen

Christian G. Drehsen, MD · Answer

After reviewing your scar, I would suggest 2 options. 
1) If you are not satisfied with the results, if you think they are still too full, additional liposuction with scar revision would be a great option. 
2) If you are satisfied with the results, then I would recommend a series of CO2 Laser. I use the CORE CO2 Laser in "Fusion Mode" with excellent results.
Christian Drehsen, MD

Deborah Sillins, MD · Answer

you may want to try some silicone sheeting. you can buy it at the drug store in tape form and place it on you scar all night and as much time during the dat.

Harry T. Haramis, MD, FACS · Answer

Steroid injections and laser may help. Scar revision may be considered as well.An exam and consultation with a/your plastic surgeon is recommended to discuss your options and expectations.

Edward I. Lee, MD · Answer

Thank you very much for your question and your pictures. It looks like you have a scar that is both wide and red. It has already been over a year so it looks like it has had time to mature. With that said, you can try some of the available scar treatment modalities (if you haven't already done so), to see if this would improve over time. These modalities may involve some combination of taping, scar cream and massaging. 
You can also try steroid injection and/or laser to decrease the "redness" of the scar. These treatments will not make the scar go away, but will make it less "red," which generally makes the scar less "visible."
A scar revision is also an option and scar revisions generally improve the scar. I would recommend seeing your board-certified plastic surgeon to go over these options.

Leon Goldstein, MD · Answer

Your present scars have not matured yet. My advice is to wait until the scars are softer and less red to evaluate their appearance.Treatments then could involve local steroid injection and/or laser. The alternative would be a scar revision changing the present straight line into a lazy S that usually heals with much less vigorous scar. Talk to your ASPS surgeon.

Bernabe Vazquez, MD · Answer

Scars from arm lift surgery are often less than perfect but steps can be taken to minimize the usual complaints. First off placement of the scars in such away that they are the least visible in any position is critical. This is done by having the patient stand in front of a mirror and determining where they will be less visible. During the surgery a combination of liposuction and conservative removal of excess skin is important. Once scars have widened then the best course of action if any residual laxity exist is to re-excise the scars under minimal tension. Post operatively I have found that Kinesio tape is the most effective in preventing scar hypertrophy. In patients that react to the tape my next choice of treatment is Bio Corneum.   The photos that you show appear as if the scars have not totally matured which means that once the redness decreases they may look better but the width of them makes me think you would benefit from their re-excision. Best of luck, you still can hope for an improved result.

Praful Ramineni, MD · Answer

Arm lift scars can tend to be hypertrophic/keloid in certain patients.  Your scars do seem wide.  In general after about a year post op, there won't be much improvement.  Laser treatment/kenalog injections may help.  Alternatively, excison of the scar with a short (5 day course) of radiation can sometimes show dramatic improvement.

What can I do about arm lift scars? I'm a year post op. (photos)

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