How Long Will Arms Stay Swollen After Bracioplasty?

Question

its been 4 months. the arms look great but they are still swollen and tender to the touch. i can feel when they are swelling and getting tight. especially with temperature change. any sugestions or coments are appreciated. thank you  Update: Dr. Neinstein, you said prolonged swelling could be a sign of other things. What do you mean by this?What else could the problem be?

Joshua Cooper, MD, FACS · Answer

-Swelling after an arm lift (brachioplasty) is expected, with most of the swelling resolving by 3 months after the procedure. 

	-However, some patients, such as yourself, will have continued swelling beyond 3 months that can be annoying. 

	-It is likely that over the course of another 3-6 months, this swelling will resolve completely.  I realize it's hard to be patient for the swelling to resolve, but time, more than any other therapy, will allow the swelling to improve.

	-Thanks for sharing!

J. Timothy Katzen, MD, FACS · Answer

Dear mrs.impatient,

Swelling after a brachioplasty (arm lift) is entirely normal, but the duration and extent can vary among individuals based on various factors, including the extent of the surgery, individual healing response, and post-operative care.

Post-Operative Swelling Timeline:

Initial Swelling: Most pronounced swelling occurs in the initial days to weeks after the surgery.

Residual Swelling: It's not uncommon for some degree of swelling to persist for several months post-operatively. By the 3-6 month mark, a significant portion of the swelling should have subsided, but minor residual swelling can continue.

Prolonged Swelling: If you're experiencing prolonged swelling, especially if it's associated with tenderness or tightness, there could be a few reasons:

Seroma: This is a collection of clear bodily fluid that can accumulate at the surgical site. It may cause swelling and discomfort.
Lymphatic Disruption: The surgery can sometimes affect the lymphatic drainage of the arms, leading to lymphedema or swelling due to lymph fluid accumulation.
Infection: While less likely at the 4-month mark, it's worth considering if there are other signs like increased redness, warmth, or fever.
Tissue Reaction: Sometimes, the body can have prolonged inflammatory responses to sutures or other aspects of the surgery.
As for the swelling you feel with temperature changes, it's possible that the sensory nerves are still healing, and the tissues are adjusting, leading to these sensations. Nerve regeneration and tissue remodeling can take many months and even up to a year or more in some cases.

Given your concerns and the duration of your swelling, it's crucial to schedule a follow-up with your plastic surgeon or seek a second opinion if needed. They can evaluate your arms directly, conduct any necessary tests, and provide insights and interventions tailored to your situation.

Your well-being and satisfaction with the procedure are paramount. Seeking professional guidance will ensure you're on the right track to a full and successful recovery.

Sincerely,
Dr. Katzen

Richard J. Bruneteau, MD · Answer

The wound healing process following arm lift surgery lasts for over a year. Most of the swelling resolves in six to eight weeks, but small amounts of swelling may persist for up to a year. The procedure inevitably interrupts the arm lymphatic drainage and this takes time to re-establish itself.Patients can minimize swelling with compression garments, massage and limitations on activity levels. It's important to remember that swelling is a normal part of wound healing and should resolve with time.Significant swelling four months after surgery should be evaluated by your plastic surgeon. In the vast majority of cases, this swelling is probably normal, but in a small percentage of patients, it might represent a problem. Under these circumstances, it's appropriate to perform an evaluation.If you're concerned about persistent swelling following arm lift surgery, it's appropriate to discuss this issue with your plastic surgeon. Your surgeon should be able to answer your questions and alleviate your anxiety.

Ryan Neinstein, MD, FRCSC · Answer

Swelling after armlift can last up to six months maybe even a year, I like to have my patients have massage therapy going from the hand towards the armpit. Prolonged swelling can be a sign of other issues and I suggest you follow up with your plastic surgeon

Kenneth Hughes, MD · Answer

At 4 months you will still have remodeling that will occur for another few months or so. Kenneth Hughes, MD Los Angeles, CA

C. Bob Basu, MD, MPH, FACS · Answer

Swelling can persist several months after surgery.  Continue to use compression garments to keep the swelling down.

Myles Goldflies, MD · Answer

As I am sure you have heard many times, "wound healing takes a year." (One of the 10 commandments of surgery!) This is because there are different processes that happen at different times after a procedure. Patients don't expect this with aesthetic surgery, that somehow it is different. My suggestion for the swelling is to get a set of compressive arm sleeves based on your present measurement. This may help keep swelling under control based on your paying attention to what you have been doing before you get the swelling. I had a patient years ago that was wondering why her arms weren't improving at around your time, when it turned out her problem was getting into a hot tub before going to bed. Also if you have areas of tenderness, a vibrating massager often will desensitize those areas and soften persistent swelling.

Jeffrey Zwiren, MD · Answer

These cycles where the arms swell more during the day and are better in the morning is common after brachioplasty surgery and will resolve over the next 3  - 6 months.

Constance M. Barone, MD · Answer

Firm massage can help not only with the swelling but also with the sensitivity. Place any type of lotion on the opposite hand and firmly massage the scar and under arm 3 x a day for 20 min each. That should help. However wound healing is not fully complete for a year to a 1 1/2 so be patient.

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