Swelling in the forearms after brachioplasty. Incorrect compression garment?

Question

I had a Brachioplasty 2 weeks ago. I have been wearing a compression garment that had 3/4 sleeves that my doctor ordered for me. I still have pretty significant welling in my forearms, seeming to start right where the compression sleeve ends. Do I need a compression sleeve that goes all the way to the wrist? Will that help the swelling in the forearms?

J. Timothy Katzen, MD, FACS · Answer

It sounds like the arm compression garments are leading to forearm swelling or edema. I would not suggest a compression sleeve that goes to the wrist. Instead, I would suggest an Ace bandage that extends from your fingers to the edge of the compression sleeve. First, I would place this Ace bandage. Then I would put the arm compression garment. This will force fluid towards your heart. I would also suggest keeping your elbows straight and your wrists above heart level. After an arm lift or brachioplasty, all these maneuvers will help minimize swelling in the hands and wrists. When I perform a brachioplasty or arm lift, I always wrap my patient's hand, forearm, elbow, and upper arm with an Ace bandage. At the end of an arm lift surgery, I place the Ace bandage.  This bandage helps to minimize swelling in the hands, forearms, and upper arms. I leave the Ace bandage in place for approximately 10 to 14 days. Once the arm incision is well healed, then I convert to compression garments. The arm compression garment stays in place for 4 to 6 weeks.Hand, wrist, forearm, and upper arm edema are usually transient after an armlift.  After an arm lift or brachioplasty, upper extremity edema may take 4 to 6 weeks to dissipate, but the swelling usually does eventually disappear. Good luck. Congratulations on undergoing a brachioplasty. Please remember to wear your compression garments, apply silicone cream, and silicone sheeting for optimal arm lift scar results. If you have any questions, please not hesitate to contact my office. Sincerely, Dr Katzen

Young R. Cho, MD, PhD · Answer

Thank you for your question.  I would elevate the arms to above the level of the heart as much as you can when you are resting or lying down.  This will help considerably.  You can also get full length compression garment that may help.Also let your plastic surgeon know as the garment may be too tight.

Francis Johns, MD · Answer

Thank you for your question. If you are two weeks out from surgery, you could try decreasing the amount of time you're wearing the garment. You could switch to  wearing during the day or wearing at night, whichever is more comfortable. This may help alleviate some of the swelling in the forearms.  If you don't notice a difference with this, then switching to a full length arm garment would be a another option.  Good luck with your recovery.

Shim Ching, MD · Answer

Swelling in the forearms is common.  What you are describing may benefit from a garment that extends out to the wrist.  Please see your surgeon who can best advise you on a change of garment.

Harry T. Haramis, MD, FACS · Answer

As long as the sleeve is not too tight at the foreman, you can add a forearm portion or ace bandage wrapped from the hand over the forearm.Close follow up with your plastic surgeon is recommended.

Onelio Garcia Jr, MD, FACS · Answer

Thank you for your question, it is not uncommon to see forearm edema post op brachioplasty.  Elevating your arms over a pillow may help.  Also try opening and closing your hands it may help with the edema.  If you are going to wrap the forearm portion, strongly suggest to be done by your physician.

Ven Erella, MD · Answer

Thank you for your question. Please talk to your PS and ask for evaluation and make sure garment is not acting like a tourniquet

Tom J. Pousti, MD · Answer

Congratulations on having undergone the arm lifting surgery. Best to address your concerns directly with your plastic surgeon; have him/her check to make sure that the garment is not acting as a  tourniquet. Best wishes for an outcome that you will be pleased with long-term.

Julio Clavijo-Alvarez, MD, MPH, FACS · Answer

Congratulations on your procedure, and thank you for your
question.

Swelling is a must after arm surgery. The use of compression
garments have the consequences that you described. Swelling of the areas that
are not included in the garment. Sometimes this becomes very painful to most of
the patients. That is the reason that supports the use of ace bandage. However,
there is dilemma among surgeons about this topic.

Some surgeons prefer sleeve dressings because applies a
steady pressure to the whole arm, preventing wrongly placed ace wraps from
giving swelling to the forearm (tourniquet effect).

Some others like me hate these compressive garments, because
they are very tight, they hurt, and is torture to try to remove them or
reposition them during the early stages of surgeries.

Remember, many surgeons put the garments while you are
asleep, and most of them do NOT go through the torture of removing them in your
first visit. Usually nurses go through the pain of doing the removal.

Then, who is right?

If the ace bandage is placed with proper pressure at the arm
level, you should not have any swelling in your forearm.

If there is some swelling in your forearm, then start
wrapping from your wrist and upwards. Then you will have the best of both
worlds.

As always, make sure that you discuss these topics with your
plastic surgeon to get to the best middle point.

Once again, congratulations on your surgery.

John Dean, MD · Answer

Your sleeves may be too tight. If it is OK with your surgeon, you may be able to try to wrap your forearms with an ACE wrap, use a looser compression garment or just stop wearing any compression at all.

Swelling in the forearms after brachioplasty. Incorrect compression garment?

Answers (11)

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