Incision opening. Should the wound be stitched since it is unstable and opening wider (Photo)

Hard to respond without seeing in person. I might put temporary retaining sutures in the areas. But if your surgeon will not than you either have to change to a new surgeon or ride it out. If you want to see me Monday call my south Miami office. To repair fee would be $750...

Thank you for your question regarding incision opening following a brachioplasty or arm lift. From your provided history and physical, it's crucial to immediately consult with your arm lift plastic surgeon, as each surgeon has unique treatment methodologies for such situations.
In most cases, plastic surgeons prefer conservative treatments for wounds of this nature. Often, the approach involves allowing the scab to shed naturally or having it professionally removed. Once this is done, Wet To Dry Dressings can be applied to facilitate healing via secondary intention. Directly stitching the wound isn't typically recommended, as this can potentially trap bacteria, leading to infections which can exacerbate the wound.
Over time, the wound stabilizes, paving the way for granulation tissue development. As this granulation tissue matures, Wet To Dry Dressings are ceased and a specialized cream is applied to stimulate the granulation tissue, promoting skin growth over it, ultimately sealing the wound.
It's worth noting that complications, like wound openings in the axilla, can occasionally arise post-arm lift due to the high tension area, the presence of hair follicles, and sweat glands. Even when the surgery is executed flawlessly, these elements can sometimes lead to infections and wound separations.
In summary, it's imperative to maintain close communication with your plastic surgeon to determine the best course of action tailored to your specific situation. I trust this offers insight into your concerns regarding the incision opening and its management post-brachioplasty.
Best wishes for your recovery,
Dr. Katzen

At this point it is best to manage this incisions with dressing changes.  Allow the wound to heal and come back in several months for any scar revision.  Good luck.