9 months after brachioplasty, scar feels very tight? (Photo)

Question

For the past few days the brachioplasty scar on my left arm is feeling very tight, especially when I'm sleeping, is this normal? A little background - I had brachioplasty in December followed two weeks later by emergency surgery to reopen my left arm to treat acute compartment syndrome which caused nerve damage (brachioplexus injury) - that's healing but the crushing pain has recently returned as well. Scars are hypertrophic scars and I've had steroid injections, last one was two months ago.

Francis Johns, MD · Answer

Thank you for your question.Although you are many months out from surgery, your body is still healing. It can take a year or more for nerve regeneration after a surgical procedure. As those nerves are healing, you can experience many different sensations. The scars do look hypertrophic which can cause a lot of discomfort. Have you tried silicone sheeting and massage. You should ask your surgeon if they have it at the office, it works really well in these type of scars. Good luck.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your interesting question regarding tight-feeling scars nine months after a brachioplasty. Thanks for your history and pictures. I'm sorry to hear you had acute compartment syndrome and nerve damage. This is rare after an arm lift, but I hope you are much better now. I think the tightness that you feel is unrelated to the compartment syndrome. The tightness you feel is more due to scar healing than anything else. In regards to the scar, it appears to be healing well. However, you may consider scar release. This can include manipulations such as micro-needling or making small incisions within the scar to help break it up the scar. If it becomes exceptionally tight in an extreme situation, you may need a Z plasty, but this would be in an extreme case. I would continue with steroid injections, and you may even want to consider micro-needling the scar to help free up some scar tissue. Good luck. I hope I helped answer your question about tight-feeling scars nine months after a brachioplasty. 
Sincerely,
Dr. Katzen

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

I would recommend that you discuss this question with your surgeon as every surgeon has their own respective post op protocol for his/her patients.  Your surgeon is your best resource as he/she is most familiar with your medical history and how you are healing at this time.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

Ira H. Rex III, MD · Answer

As far as your body is concerned, you are still in the early stages of healing. Scars tend to soften up over time. It is difficult to assess whether your symptoms are from hypertrophic scars or, less likely, nerve problems. You should follow these closely with your plastic surgeon as you continue to heal.

Aldo Guerra, MD · Answer

Thank you very much for your question and photos. I'm sorry to hear about your brachioplastu experience and wish you the very best as you continue to recover. You do have hypertrophic scarring which is common with brachioplasty. I would suggest a check up with your plastic surgeon to find out the cause of your most recent discomfort, especially if there's increaing pain. Best wishes always, Dr. Aldo

Bram Kaufman, MD · Answer

Scarring can take many directions after surgery.  Although the wound has been healed for many months, the scars will continue to mature. Part of this maturation can include some scar shortening or tightening. This often improves with more time and with some maneuvers such as scar massage, silicone treatments, steroid injections among others. Your case is unusual in that your scars and the operative site have been through so much. At 9 months after surgery, it would be very unlikely that anything particularly dangerous is occurring. Your best bet is your physician's careful history and examination. They have the best frame of reference and insight into your history and previous examinations. I hope this helps.Best of luck

Tariq Ahmad, MBBChir, FRCS(Plast) · Answer

Hi there, and thank you so much for this question.
This scar does not seem to have stretched overly much but may be still a little thick, and therefore tight. The profile of the arm looks very good, however. 
Progress in the healing process and maturation of scarring can be different in different individuals but some patients are prone to thick or tight scarring. 
Massage, pressure and topical treatment such as silicone gel or better still silicone gel tape can help; steroid injection can soften and relax the scar at the risk of the scar stretching. 
I cannot see the upper and lower ends of the scar but i will usually place a Z-plasty at the upper and lower ends to reduce tightness and bow stringing in the scar; if not done it could be another option to relax the scar.
I do hope that this answer has been helpful for you and my very best wishes for your continuing improvement in the arm profile and scarring.

Zachary Farris, MD, FACS · Answer

Thank you for your question.  In addition to steroid injections, massage and silicone sheeting may be beneficial.  Please discuss your concerns with your surgeon, especially since you had a complicated course.  Good luck.

Morris Ritz, MB, BCh, FRACS · Answer

The scarring can take some time to heal even now. I would contact your surgeon to discuss the options to help relieve some of the discomfort. Either a cream or gel for the scar, or some silicone tape. There are a few options to try and improve it.

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