Should I be worried that my wound is bleeding 4 weeks after my arm lift? (Photos)

Question

About 2 weeks post op, the incisions in my arm started to open at my arm pit. My PS said don't worry it will heal by itself. Just wash it with soap and water, apply hydrogen peroxide, and apply alcohol, then dress it with a gauze and wear my compression sleeves. I do that daily. However, I feel like the wound is getting worse. It wasn't bleeding before, but now, at 4 weeks post op, it leaks blood when I remove the dressings to clean it up. Should I be worried? How long will it take to heal?

Yannis Alexandrides, MD, FACS · Answer

This is what I would call a dehiscence. It looks as though it's quite a wide area, and local care would be necessary. However, I would not apply alcohol.  Use an antibiotic treatment when it looks as though it is starting to improve a little.

J. Timothy Katzen, MD, FACS · Answer

Hello, thank you for your questions regarding bleeding after an arm lift or brachioplasty. I am sorry you had this unfortunate event. From your pictures and limited history, it appears that there are no signs of any infection. I would suggest you follow up with your plastic surgeon. I believe you are doing all the right things. However, personally, I would not use alcohol. I think alcohol is too harsh or stringent to the wounds. I would also suggest you apply a topical moisturizing antibiotic like bacitracin.  bacitracin can help to accelerate healing. As wounds heal, there is an increase in blood flow to the wound. In general, as wounds heal, blood rushes to the wound and thus, bleeding from wounds (like these) can be a good sign. In terms of when will these arm wounds heal, that is entirely up to your own healing capacity. It depends on your age, nutrition level, overall health, and genetics. High protein intake of 100 g or more a day, multivitamins, extra vitamin C, zinc, and magnesium will all increase your wound healing capacity. You may even consider hyperbaric oxygen to accelerate healing. Again, thank you for your questions regarding bleeding four weeks after an arm list or brachioplasty.  If you have any questions regarding wound healing after your arm lift, please contact my office. Sincerely, Dr. Katzen

Marie E. Montag, MD · Answer

A brachioplasty is a great procedure to remove excess skin and fat from the upper arm, but due to the constant movement that happens in that areas as you use your arms it does have a tendency to have some delayed healing. It is not uncommon to pop a couple of stitches and have areas that have to heal in from the edges. The fact that you have some oozing/bleeding when the dressing comes off is actually a good sign. It means that the tissue in the base of the wound is healthy and has good blood supply. The dry crusty spots and scabs look like they have cleaned up from the dressings you have been doing! Once a wound ‘cleans up’ like that it starts to heal in much faster. From the look of things I would bet they are all closed up in a week or two! Certainly keep a close eye on them and let your plastic surgeon know if anything changes or the bleeding increases, but it seems like you are on the right track!

Gary L. Ross, MBChB, FRCS · Answer

You have a problem with the heading of your scars with some breakdown and granulation. It is going to take a number of weeks for this to heal and you need advice from you PS regarding dressings and subsequent scar management. This will heal.

Nodas Kapositas, MD, PhD · Answer

This a typical delayed wound healing photo after an arm lift and you do not need to worry.Follow the instructions (local care) that your plastic surgeon who did the procedure gave to you and the wound will  completely close in the next period (3-4 weeks).

Frederick G. Weniger, MD, FACS, MBA · Answer

Thank you for the question and photos.  The current photo you have, the wound looks very healthy. After surgery the incisions can open like yours has and a wound will tend to get worse right before it starts to heal.  The bleeding you see  is a good sign, healthy tissue bleeds.  Continue to do the wound care your Board Certified Plastic Surgeon has you doing and continue to follow up with the office.

Regina M. Fearmonti, MD · Answer

The wound looks irritated-perhaps sutures are spiting and/or frictional forces (a sleeve, exercise) are causing some ongoing irritation.  Try keeping the wound open to air after showering and avoiding dressings/ointments. When all areas are dry, an emollient moisturizer such as Aquaphor can be used to massage the scar and keep the wound from cracking. This will heal on its own.

Karen Quigley, MD · Answer

Your areas of concern certainly look superficial. Sometimes the subcu sutures do what we call "spit" and cause problems like this. You might be able to decrease the bleeding by using some antibiotic ointment on the areas and covering them with a no stick type dressing such as telfa pads. The incisions from a brachioplasty can be problematic for awhile but eventually they resolve. Continue as you are doing, to keep in close touch with your plastic surgeon.

Franklin Peña, MD · Answer

Thanks for asking. Given your concern I can comment that this type of breakdown in arm liposuction can happen. In the photograph you can see that the wounds are superficial, in their case they look healthy, a little red and they can bleed a little.You do not see infection in the tissue, it seems that it could take a little longer your healing. But not to worry.

Darryl J. Blinski, MD · Answer

Doing large areas of surgery in one operation the risks of postop complications increases. You have a wound healing postop complication that needs every other day in person follow up in my over the RS internet opinion. I might offer PRP infusion therapies wth red laser external txt.

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