Arm Lift - armpits not healing well

Question

I am three weeks post op and the arm pit scar where it joins remains open a bit. The rest of my scars are healing well. I am use silicone tape and it is helping to flatten things out. I am wondering if there are any ideas to encourage closure.

Ira H. Rex lll, MD · Answer

This is a very common situation where there is a small amount of skin breakdown at the very top of the armpit. In almost all cases, this will heal without a problem on its own. This can take many weeks. I think the most important management will be to keep the area clean with soapy water and apply a small dry dressing.

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding your armpits not healing well after an arm lift.  Incisions in the armpit are notorious for poor healing.  Poor armpit healing is partially due to the anatomy of the armpit or axilla.  The armpits contain sweat glands, hair follicles, and lymph nodes.  Interruption or partial sweat gland removal can lead to poor healing and armpit infection.  The armpit hair follicles can harbor bacteria in the hair shaft and cause infection.  Removal or disruption of the lymphatic vessels can also cause poor wound healing.     In addition, the medical-grade garment or ace wraps, used to keep bandages in place, can also rub against the armpit and cause wound breakdown.  Additionally, the armpit is susceptible to wound breakdown because of the joint's mobility. 
You'll need to follow up with your plastic surgeon regarding their preferred method of wound closure.  Because the armpit wounds are open, the open wounds should not be closed.  If your armpit wounds we surgically closed, you might develop an infection, which could cause further opening of the armpit incision.  Surgically closing the armpit could also cause slow healing.  Typically, most armpit incisions are left to heal with a technique called healing by secondary intention.  That means the depth of the wound heals first, and then the edges come together.  Bacitracin or Venelex are good topical creams to accelerate healing.  Alternatively, mupirocin can be used in patients who are highly susceptible to MRSA infections.  If the wounds are deeper, they may require wet-to-dry dressings with normal saline or Dakin's solution.  Supplemental modalities to accelerate wound healing include hyperbaric oxygen.  Hyperbaric oxygen supplementation forces oxygen into the tissues and promotes wound healing.  Regarding systemic products, most plastic surgeons would encourage extra vitamin C, zinc, and magnesium.  These have been medically proven to accelerate wound healing.  Most plastic surgeons suggest that you do not place silicone on open wounds.  This will slow wound healing.  Thank you for your question regarding your armpits not healing well after an arm lift.  I hope I have answered your question regarding what to do about armpit openings and wounds after an arm lift.  If you have any questions regarding the arm lift, arm reduction, or brachioplasty, please get in touch with an arm lift expert.     Since a brachioplasty or arm lift surgery is difficult, 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 150 arm lifts.  Make sure they have the before and after pictures to prove it. Please carefully look over their before and after pictures and check their reviews on RealSelf.   Sincerely, Dr. Katzen.  (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.)

Keshav Magge, MD · Answer

Than you for your question.  In areas of high tension, it is not unusual to have some delayed healing.  This will heal, but it will take a little time.  Keeping the area clean with soap and water will encourage a clean area for wound healing.  After the scar is closed, you can use the silicon tape on this area as well.  If it is poorly healed scar after a year, it could always be revised, but most likely it will heal fine.  All the best,

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your post. Unfortunately the arm pit is a difficult area to heal because of 
frequent motion and high normal bacterial counts, sweating, etc. Arm 
lifts therefore occasionally have problems like this, especially in the 
axilla (arm pit).
	The most common reason would be absorbable sutures that are reactive and being pushed out  through the the skin.
	The good news is that your arm lift will heal. It just needs more time.
	I recommend to see your board certified plastic surgeon to be checked.Good luck :)

Owen Reid, MD · Answer

A small area of wound separation and delayed healing is not uncommon and these wounds will typically heal spontaneously over a period of a few weeks. Suggestions:keep the area clean by washing normallykeep the area dry by minimizing sweating and maceration of the skinreduce friction and stress on the area to the extent possiblemaintain your shoulder range of motion, it's important that you don't develop any joint stiffnesssee your PS and make sure there's no underlying problem such as infection, seroma or hematomano silicone tape on this area until it has healed over

Arm Lift - armpits not healing well

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Answer: Armpit

Answer: Armpit

Answer: Delayed healing after arm lift

Answer: Delayed healing after arm lift

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Arm Lift - armpits not healing well

Answers (6)

Answer: Armpit

Answer: Armpit

Answer: Delayed healing after arm lift

Answer: Delayed healing after arm lift

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Everything you need to know about Arm Lift

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