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3 weeks ago I had a scar revision zplasty because armpit was webbing and I couldn't stretch; implant exchange pocket revision. original brachioplasty scars that extend to my elbow are extremely painful. I've tried silicone sheets, mederma, oil, coco butter, lazer and am just miserable. My zplasty also busted open so the armpit scar is horrendous. Any one have any suggestions on treatment, I am just miserable. I realize they did a lot of surgery removing 2lb from each arm. Thank you!

Yannis Alexandrides, MD, FACS · Answer

This sounds like a difficult situation. If you haven't already tried kenalog injections, then I would advise you try this.

J. Timothy Katzen, MD, FACS · Answer

Hello W,390042 in Brandon,
Thank you for reaching out with your concerns about the complications following your Z-plasty for webbing and the associated pain at your elbow. Addressing these issues effectively is crucial for optimal healing and functional recovery.
Healing of Z-Plasty: If the Z-plasty has burst open, it’s essential to first focus on allowing it to heal completely. This might involve using wet-to-dry dressings, creams, or ointments to facilitate the healing process. The key is to create an environment conducive to tissue repair without further aggravation.
Future Reconstruction Options: Once the area has fully healed, reassessing the situation is important. Depending on the outcome, another Z-plasty or a scar revision might be necessary. The choice of procedure will depend on the extent of scarring and the specific issues with the initial Z-plasty.
Scar Management: Options for scar management could include steroid injections, 5-fluorouracil (5FU), dermabrasion, or microneedling. These treatments can help reduce scar tissue formation and improve the appearance and functionality of the scar.
Pain at the Elbow: The pain you’re experiencing at your elbow could be related to scar tissue formation from the brachioplasty. Injections of steroids or 5FU might help alleviate this pain by reducing inflammation and breaking down scar tissue. Additionally, deep tissue massage can be beneficial in breaking up scar tissue, thereby reducing pain and improving mobility.
Avoiding Wound Aggravation: It's crucial to minimize activities that could strain the affected area or cause the wound to reopen. Excessive arm movement and friction from clothing or other forces should be avoided during the healing process.
I recommend staying in close communication with your plastic surgeon or a specialist in reconstructive surgery to manage these issues effectively. They can provide personalized guidance and treatment based on the specifics of your case.
Your patience and diligence in managing these issues are essential for achieving the best possible outcome. I hope this advice helps you navigate your healing process and provides clarity on the next steps.
Wishing you a smooth recovery and successful resolution to these concerns.
Sincerely,
Dr. Katzen

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