Will lymph nodes be damaged or removed during brachioplasty and upper bodylift?

Question

I've had a 350 pound weight loss resulting in excessive skin. I am wondering if procedures that remove the excess skin, such as a brachioplasty and upper body lift, cause a risk to damage of the lymph nodes? If there is a risk, what kind of problems could result?

Aldo Guerra, MD · Answer

When I've done arm lift surgery before, I make sure to stay out of the lymph nodes in the underarm area. There's a small, thin fascia that covers the area where the lymph nodes are located and it's pretty easy to find and identify during surgery. If lymph nodes are removed, a person may experience prolonged swelling or lymphedema.

J. Timothy Katzen, MD, FACS · Answer

Congratulations on your significant weight loss and best wishes for your upcoming surgery. Your question regarding the potential impact of an arm lift (brachioplasty) or upper body lift on lymph nodes is an important one.
In a standard arm lift, brachioplasty, or upper body lift, lymph nodes are typically neither damaged nor removed. This holds true even though the incision for these procedures might be placed in the armpit area, where lymph nodes are located. Surgeons performing these procedures are skilled in navigating around important anatomical structures, such as lymph nodes, to minimize any risk of harm.
It's always a good idea to discuss these concerns directly with your surgeon preoperatively. They can provide more specific information based on the surgical technique they plan to use and any unique aspects of your anatomy.
I hope this answers your question and alleviates any concerns you might have regarding the effect of your upcoming surgery on lymph nodes. Wishing you a smooth surgery and a speedy recovery.
Good luck!
Sincerely,
Dr. Katzen

Stefan Mark Szczerba, MD · Answer

I guess it is a risk but frankly I've never heard of that.  The lymph nodes live in the actual axilla and this operation is more on the skin level along with the underlying fat.  If the arm lift extends down from the arm and onto the torso, unwittingly a lymph node could be taken with the excess skin.  I think the risk of chronic arm swelling beyond the area, called lymphedema could be possible.  Little nerves do live in the area and that injury is more common. My recommendation would be to talk over the pattern of excision with your surgeon and discuss with him or her what anatomic structures are at risk and what can be done to minimize the risk.  Best Wishes!!

Ashley Thorburn, MD · Answer

Lymph nodes may be affected during brachioplasty (arm lift) and upper body lift procedures, but they are typically not intentionally removed. Surgeons aim to preserve lymph nodes as they play a crucial role in the body’s immune system and fluid drainage.However, during these surgeries, lymphatic vessels may be disrupted or temporarily affected, which can lead to localized swelling or lymphedema. Surgeons take precautions to minimize damage to the lymphatic drainage. It’s important to discuss the specifics of your surgery with your surgeon to understand any potential risks and how they plan to protect the lymphatic system during the procedure.

Charles W. Spenler, MD · Answer

Thank you so much for your question and congratulations on your weight loss! The major concentration of lymph nodes are located in the axilla and this procedure should not disrupt them. During a brachioplasty, we are simply removing excess skin and fat and should not be in your axilla at all. I would recommend that you find a board certified plastic surgeon in your area with experience in brachioplasty. It is possible, that a surgeon could be too aggressive and disrupt the lymphatic drainage which could cause swelling.

Richard Bloom, MBBS (Hons), FRACS · Answer

Hi there Desales and thanks for posting,Firstly congratulations on your weight loss - that is an amazing effortAs with any surgery there are risks associated with brachioplasty, but damage to the lymph nodes should not be one of them. The surgery should all be quite superficial to where the nodes are so they should not be affected.Chronic lymphodema is a known but rare risk associated with brachioplasty, that is more likely to be related to damage to lymphatic vessels rather than the nodes.Best wishesRichard

Adam Goodwin, MBBS, FRCS(Plast) · Answer

so there is an anatomical boundary between the skin and fat of the arm to be removed in an arm lift and the vital structures of the upper arm and axilla, namely the vessels nerves and nodes. It is called the brachial fascia and is a pretty unmissable structure during this type of surgery. A couple of tiny nerves can be pulled or cut resulting in some numb patches around the surgery but these usually resolve over time. Hope that helpsAdam Goodwin

Jon Ver Halen, MD, FACS (license suspended) · Answer

Hello and thank you for your excellent question. After having performed many brachioplasties over the last 15 years, I have not injured any lymph nodes with the procedure. However, significant postoperative swelling is very typical. Consequently, you want to be sure to fastidiously adhere to using your compression garments postoperatively to speed your recovery and maximize your results. If you are going to have surgery, the decision should be made with equal input from you and your surgeon. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck!

Best,
Jon Ver Halen, MD FACS

Harvard educated plastic surgeon

Best,
Jon Ver Halen, MD FACS

Harvard educated plastic surgeon

Will lymph nodes be damaged or removed during brachioplasty and upper bodylift?

Answers (8)

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