Limited ROM, pain, banding/webbing, hypertrophic dark scars, adhesions 9-mos post brachioplasty. How would you fix my arm? (pix)

Question

I am in OT 1x/week and ASTIM 2x/week for limited ROM caused by brachioplasty in Oct. Therapist says skin cannot stretch as it's healed. The collagen is out of whack and it reminds her of a burn victim's scar. Scar tissue and adhesions in the arm and webbing in the axilla prevent ROM. PS did a zplasty in March to lengthen the scar but tissues were so degraded that it opened 4x. Zplasty did lengthen the scar but not by enough. I am scared. Will I ever have normal ROM and wear short sleeved shirts?

Robert F. Centeno, MD, FACS · Answer

Thank you for your question and photos.  It is very uncommon for axillary scarring to cause permanent loss of ROM, especially in patient who have had weight loss.  Yours scars are significantly hypertrophic leading in large part to the symptoms you are experiencing. A Z-plasty was a reasonable first attempt to address this issue. I would recommend a series of kenalog injections to soften the scar, silicone sheeting and arm exercises (walk your arm up the wall with your finger 5-10 times per day).  This will help the scar to loosen up and improve your range of motion. If that is not completely successful, the next step would be to perform a larger z-plasty to lengthen he scar further.  Keep the line of discussion open with your surgeon and you will likely continue to improve. Best wishes on your recovery.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your pictures. Sorry for the complications. All the appropriate measurement of been taken. I will allow for healing in the area. Aggressive physical therapy may be your best and only option at this point. Please keep yourself sufficient time (6-12 months) to see improvement.

Darryl J. Blinski, MD · Answer

This is a very common post operative issue from over resection in a brachioplasty operation. Sounds like you are having corrections done. Can not add more..

Constance M. Barone, MD · Answer

It is very unusual to have limited ROM especially after weight loss.   Continue massage, silicone sheeting and compression garments.   If this does not improve then a repeat , largery Z-plasty should be done in the axilla, followed by a skin graft.   Best to you

Jeffrey Zwiren, MD · Answer

It appears that you had a lot of problems with wound separation after your arm lift.  This is cause you to have a scar contracture in the form a web.  If therapy does not make this better then you will need a procedure called a Z-plasty which will lengthen your scar and drastically improved your range of motion.

Limited ROM, pain, banding/webbing, hypertrophic dark scars, adhesions 9-mos post brachioplasty. How would you fix my arm? (pix)

Answers (5)

Answer: Limited ROM, pain, banding/webbing, hypertrophic dark scars, adhesions 9-mos post brachioplasty. How would you fix my arm?

Answer: Limited ROM, pain, banding/webbing, hypertrophic dark scars, adhesions 9-mos post brachioplasty. How would you fix my arm?

Answer: Healing problems after an arm lift surgery

Answer: Healing problems after an arm lift surgery

Recommended reading

Everything you need to know about Arm Lift

Our mission is to create a world where every investment in modern beauty is Worth It.

Limited ROM, pain, banding/webbing, hypertrophic dark scars, adhesions 9-mos post brachioplasty. How would you fix my arm? (pix)

Answers (5)

Answer: Limited ROM, pain, banding/webbing, hypertrophic dark scars, adhesions 9-mos post brachioplasty. How would you fix my arm?

Answer: Limited ROM, pain, banding/webbing, hypertrophic dark scars, adhesions 9-mos post brachioplasty. How would you fix my arm?

Answer: Healing problems after an arm lift surgery

Answer: Healing problems after an arm lift surgery

Browse related questions

Recommended reading

Everything you need to know about Arm Lift

Our mission is to create a world where every investment in modern beauty is Worth It.