I had an arm lift done 2 weeks ago. It looks like my doc didn't remove enough fat/skin at all. Will they tighten up? (Photo)

Question

I had brachioplasty after losing 150 pounds 10 years ago. I waited a long time. Now that I have had it done, it looks like my doc didn't take nearly enough skin/fat off! I cry daily because this is such a massively painful thing to heal from. Will the swelling and fat looking tissue resolve itself over time?

J. Timothy Katzen, MD, FACS · Answer

Hello, rsheagren in Key West, FL
Thank you for your question regarding the fact that you had an arm lift done 2 weeks ago and (to you) it looks like your doc didn't remove enough fat/skin at all and will your arms tighten up? Thank you for your history and your pictures. You are ONLY TWO weeks from your arm lift surgery. It takes at least 6 to 8 weeks to heal from an arm lift/arm reduction/brachioplasty. It is too early to determine anything. During the 6 to 8 weeks after an arm lift, your body pumps blood to the arms. Oxygen, lymphatic fluid, and micronutrients leak from the capillaries. These conditions lead to postoperative edema, or swelling. This is completely normal. In addition, the bigger the arms, the bigger the surgery, and thus, the more swelling. The ways you can minimize swelling are to keep your elbows and wrists straight. Keep your hands above your heart and open and close your hands 15 times every hour while you are awake. Do not have your arms held by your sides. Furthermore, a medical-grade compression garment will help to minimize edema and flatten the scar. Regarding your question regarding whether your arms will tighten, the answer is yes. To what extent? That will take time. I hope that I have answered your questions regarding the arm reduction and specifically that fact that you had an arm lift done 2 weeks ago and it looks like (to you) that your doc didn't remove enough fat/skin at all and will your arms tighten up. 
If you have any more questions regarding the arm lift, arm reduction, brachioplasty, arm scar revision, or arm crease fat grafting, contact an experienced plastic surgeon. To get an accurate assessment of what exactly you need, schedule a free virtual consultation. Most plastic surgeons offer free virtual consultations. Since an arm lift can be a challenging surgery, please seek an experienced, board-certified plastic surgeon with significant experience performing these types of lifts. Do your research. Make sure they have performed at least 150 arm-lift procedures. Make sure they have the before-and-after pictures to prove it. Carefully examine their before-and-after pictures and check their reviews on RealSelf. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS, FASMBS, FASBPS (Plastic Surgeon, President of  the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery,  and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Gregory Mesna, MD, FACS · Answer

I hope your arms have continued to improve and that you have found additional assistance if necessary. There are limits to how much skin you can remove without jeopardizing your circulation and nerve supply to your forearms and hands. I would encourage you to follow up with a board certified plastic surgeon who can address these concerns to help minimize your risks of permanent swelling and numbness in your forearms and hands and also make sure that you and your surgeon have realistic goals and expectations of what the surgery can do as well as it's limitations.

William Aiello, MD · Answer

After 2 weeks your swelling is about 30-40% gone. You have at least another 4 months to go before you get to your end result. You need to be patient. Your arm is like a big sponge and will slowly lose its swelling over time. After another 2 weeks it may feel tight firm and lumpy and then that too will fade away and they will shrink more and soften. Whether this is adequate to meet your expectations I can't say but certainly 2 weeks is not remotely long enough time to evaluate this.  Have Patience .William Aiello, MD Orange County CA

Samir Shureih, MD · Answer

No they will not tighten any more.Will need revision, New surgery,  with combination liposuction and excision excess skin. Choosing the right surgeon to get the best results

Darryl J. Blinski, MD · Answer

Even though still early in healing phase appears as a very conservative excision. If after 3 months appears same consider revision.

Marissa Tenenbaum, MD · Answer

Congratulations rsheagren on your brachioplasty! It is still really early to tell and sometimes a compression garment and or an ACE wrap can help. Ask your board certified plastic surgeon if she/he thinks this would be beneficial. Though patients may want to take as much off as possible, the most important thing is safe surgery and being able to safely close the arm back up after excising skin and fat. Best, MMT

Peter Fisher, MD (retired) · Answer

Hello and thank you for your question. It's a little early to tell. Did you have liposuction as well? Before even contemplating any revision,  you need to wait 3 to 6 months. Unfortunately I believe though that you are most probably correct in that too little was removed.  You also needed liposuction if not done. Having said that it's devestating if too much is removed. Peter Fisher M.D

I had an arm lift done 2 weeks ago. It looks like my doc didn't remove enough fat/skin at all. Will they tighten up? (Photo)

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