Upper arm skin reduction post weight loss.

Question

Being a Lymphedema therapist my concern moving forward with making a decision for upper arm skin reduction would be developing Lymphedema post surgery, what are the chances of that happening?

J. Timothy Katzen, MD, FACS · Answer

After arm lift or brachioplasty, lymphedema is certainly a concern.  However, after a brachioplasty, permanent upper extremity lymphedema is extremely rare.  I believe upper extremity lymphedema occurs after brachioplasty due to damage to the axillary lymph nodes. Axillary lymph node damage can occur during liposuction. Axillary lymphatic damage can also occur if the axillary incision is too tight. Both of these potential ways to damage the axillary lymphatics can be avoided by selecting a board-certified experienced plastic surgeon.  Please seek a plastic surgeon with a significant amount of experience in armlifts. I would suggest no less than 100 arm lift patients.  In addition, I believe it's extremely important to wear compression garments for 6 to 8 weeks after an armlift. Arm elevation and arm exercises are also important to minimize edema and scarring.Good luck. Sincerely, Dr. Katzen

Jamil Ahmad, MD · Answer

Lymphedema is uncommon after brachioplasty because axillary lymph nodes should not be disrupted in this type of surgery. Additionally, avoiding deep dissection in and around the axilla likely helps avoid this problem. There are a variety of different ways to perform a brachioplasty. The appropriate technique depends on the degree of skin laxity and also the degree of fatty excess. The length and position of the scar can vary greatly depending on how much loose skin there is in the arms and if this extends to include the armpit and even the lateral chest wall. Additionally, in some cases, liposuction of the arm can greatly facilitate the surgical dissection as well as complement the result. Regardless of the technique chosen, care should be taken during surgery to avoid disrupting the rich lymphatics of the armpit.

David A. Bottger, MD · Answer

Although swelling may be present for several months post bracioplasty, lymphedema is rare. One of the major concerns with this procedure is the ultimate scar, which can,many times, be of poor quality. It s instructive to look at scar results in a number of patients to determine your tolerance. Best of luck.

Dana Goldberg, MD · Answer

Although swelling in the arms (including the hands) is common for the first few weeks after surgery, it's rare for it to last longer than a month or two, and I have personally never seen a patient develop permanent Lymphedema after brachioplasty.

Thomas Trevisani, MD · Answer

Without photos- it is difficult to comment accurately. Congratulations on your weight loss! Body contouring after weight loss is very beneficial and fulfilling and helps patients to keep the weight off. Brachioplasty, if done properly, will most likely NOT be associated with lymphedema post-operatively. The lymph nodes and the majority of the lymph vessels are located deep to the skin excision. The scar is from the axcilla along the bicep's groove distally to just above the olecranon .

Connie Hiers, MD, FACS · Answer

Lymphedema after brachioplasty is a potential risk, but very low risk. No lymph nodes are usually removed which greatly decreases the chance of lymphedema. You can minimize the risk by doing the procedure in two stages--first liposuction to decrease the fat volume of the arm, then follow with the arm tuck 3-6 months later. The second procedure concentrates on removing primarily just excess skin.

Craig Harrison, MD · Answer

Thank you for working with people suffering from lymphedema. That would be a challenging job.  In medicine you can never say never so I would say your risk of developing lymphedema is remote. I use a posterior rather than a medial resection which isn't in the neighbor of major lymphatic channels.  Best wishes

Tom J. Pousti, MD · Answer

Congratulations on your weight loss. Given your occupation, your concerns are understandable but lymphedema is extremely rare after arm lifting surgery. Remember, that the axillary lymph nodes are not  injured/removed during this operation. Best wishes for an outcome that you will be very pleased with.

Upper arm skin reduction post weight loss.

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More Arm Lift Questions

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