Tips/advice on Open Wound/cut After Extended Arm Lift. Pictures Attached- Infected? Too Big?

Question

My Dr. knows, say "keep it clean and dry w/ gauze" 5 weeks post op from Breast augmentation with extended arm lift One side open for about 20 days Smells bad, no fever, feel fine More red then what the picture looks like I try to keep it clean- I just let water/soapy bubble wash over it let it air dry & them when it feels wet tap it dry. What else can I do? How should I wash/dry it? keep it covered 24/7 or let it air out?

Richard J. Bruneteau, MD · Answer

It's not unusual for patients to have wound healing problems following arm lift surgery. The problem typically occurs where the vertical incision meets the transverse incision. This location is at risk for wound separation for a variety of reasons. These include poor blood supply to the skin flaps and high levels of bacteria that occur in the axilla. Both of these factors can contribute significantly to wound breakdown in this area.Once breakdown has occurred, wounds tend to heal by secondary intention. Tissue tends to form a layer of granulation and wounds contract. The skin grows over the top of the granulation tissue. In the initial phases of healing, there may be an intense inflammatory response that can make the wound look red and angry. Depending upon the size of the wound, this process may take 4 to 6 weeks to reach completion.For these reasons, these wounds should be monitored closely. If infection appears, antibiotics should be started immediately. In the interim, local wound care should be continued with dressing changes. When this approach is taken, wounds tend to heal nicely. Rarely, scar revision may be necessary as a secondary procedure. If you have questions or concerns about how your wound is healing, it's important that you discuss them with your plastic surgeon. Your surgeon should be able to address your concerns and alleviate your anxiety.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding what to do with open wounds after an extended arm lift. You must follow up with your plastic surgeon and with their team. His experience would guide you through the healing. Every plastic surgeon has a different way of treating wounds like this. If my patient had a wound like this, I would suggest a cream called Venelex. This cream helps to optimize granulation tissue and rapidly close the wound. In examining your pictures, there is no infection. The edges are clean, and the wound is clean. With time this will heal from the inside out. This is not an uncommon area of breakdown after an extended arm lift. This area breaks down because of hair follicles, sweat glands, and lymph nodes; in the post-operative period, you move your arm. All these factors contribute to a high incidence of wound breakdown, specifically in this area.
Nonetheless, usually when this area heals. The scar will be minimal and will heal without the need for revision. At this time, I would, however, continue to work with your plastic surgeon for optimal wound healing. Thank you for your question regarding what to do after an extended arm lift. 
I specialize in arm lifts.  I hope that I have answered your questions regarding the arm reduction.  If you have any more questions regarding the arm lift, arm reduction, brachioplasty or arm crease fat grafting, please contact my office.  Since a brachioplasty or arm lift surgery is a difficult procedure, please seek an experienced, board certified plastic surgeon with significant experience performing these types of arm lifts. Do your research.  Make sure your chosen plastic surgeon has performed at least 100 arm lifts.  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. (“Verified” 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.)

Tom J. Pousti, MD · Answer

Congratulations on having undergone the arm lifting procedure. These types of superficial separations may take a few weeks to heal. Close followup with your your plastic surgeon will be important; for example, he/she may be able to help you with exposed sutures and/or removal of unhealthy tissue. This type of local wound care may help expedite the healing process. Best wishes for outcome that you will be pleased with long-term.

Robert F. Centeno, MD, FACS · Answer

You have delayed healing in the armpit region.  The wound is not infected.  Moist wound healing is much faster than letting a wound dry out.  Keeping it moist with saline soaked gauze, antibiotic ointment or hydrogel will lead to better healing than letting it air out. Discuss this matter with your surgeon. Best wishes.

Adam J. Oppenheimer, MD, FACS · Answer

The Arm Lift procedure, or brachioplasty, involves a trade-off between loose hanging arm skin for tight arms and a longitudinal scar on the inside of the upper arm/underarm. The biggest drawback of this procedure is the potential for hypertrophic (thickened) scarring in this location. Accordingly, proper placement of the scar is crucial so that it hides on the inside of the arm when the arms are at rest (at the sides). With this placement, the scars become less visible to others. When a large arm reduction is performed, there is a risk of skin breakdown and wound development at the "L" junction, at the apex of the axilla. This is the area of greatest tension and least blood supply. In general, a wound in this area with deep "beefy" red healing (granulation) tissue at its base is not infected and will continue to heal. Dressing changes and routine hygiene is recommended, as is close follow up with the treating surgeon.

Tips/advice on Open Wound/cut After Extended Arm Lift. Pictures Attached- Infected? Too Big?

Answers (5)

Answer: Axillary Wound Delayed Healing

Answer: Axillary Wound Delayed Healing

Answer: Arm Lift

Answer: Arm Lift

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Everything you need to know about Arm Lift

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Tips/advice on Open Wound/cut After Extended Arm Lift. Pictures Attached- Infected? Too Big?

Answers (5)

Answer: Axillary Wound Delayed Healing

Answer: Axillary Wound Delayed Healing

Answer: Arm Lift

Answer: Arm Lift

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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.