Does This Gaping Hole Need Stitches? (photo)

I had an arm lift with a three way stitch, and it opened under my arm pit. I've seen my doctor twice, this hole has been open for well over 2 weeks and is draining a green liquid with a slight bad odor. He says let it heal on its own; want to get your thoughts and see if you would choose to restitch.

Doctor Answers 5

The Management of Wound Separation Following Brachioplasty

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.

Open Wound afterArm Lifting Surgery?

Congratulations on having undergone the arm lifting procedure. I think that your plastic surgeon has given you good advice;  generally speaking local wound care will work better in your situation than attempts at wound closure.

 Continue to exercise patience and continue to follow-up with your plastic surgeon.

Best wishes.

Does This Gaping Hole Need Stitches?

I agree with the plan your chosen surgeon has taken. Allow secondary closure by wound contraction and re-epithialization. 

Does This Gaping Hole Need Stitches?

As a general rule it is better to let an area like this heal on its own without resuturing. Closing the wound at this stage has a high chance of failure, and will just set you back a couple of weeks. This is not uncommon occurrence after arm lifting. Although the adjacent skin edges look not to be inflamed, you might check with your surgeon about getting a culture and using antibiotics. 

All the best. 

Opening in the Axilla After Arm Lift

     This area does open in arm lifts on a somewhat routine basis.  This is usually a small area when it does occur.  At any rate, suturing this area together is not advised.  Local wound care is best.  If there are signs of infection, which will be determined by your surgeon, more intervention may be necessary.  Kenneth Hughes, MD Los Angeles, CA

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.