Armpit open wound after brachioplasty. Any suggestions? (photo)

Question

I had a brachioplasty 2 weeks ago w a quarter size open wound in my left armpit, my surgeon is telling me to expose the area to air for a dry healing, however, I've read articles that encourage keeping the area moist w the use of Vaseline for faster healing, which do you recommend? Also, does my wound look normal or infected? My PS is 12 hours away, would it be appropriate to see my PCP for follow up and wound care?

J. Timothy Katzen, MD, FACS · Answer

Hi Marisuarez,Thank you for your questions and pictures from your recent arm lift, arm reduction, or barchioplasty.  Congratulations on having undergone an arm lift!Unfortunately, wound breakdown in the armpit is not uncommon. Fortunately, given the appropriate arm wound treatment, almost all these armpit wounds heal with conservative treatment. In my experience, that means these arm wounds do not need surgical debridement, skin grafting, or even scar revision. Your wound is open, but it does not look infected.  I would not use vasoline.  It is important to realize that every plastic surgeon has his or her own way of treating plastic surgery wounds.  I would suggest sticking with your plastic surgeon.  In this age of digital technology, I would email or text him or her these pictures. I believe these wounds can be handled over the phone. I would not involve your PCP. Involving another physician who does not specialize in wound care may complicate your wound healing and may in fact slow your wound healing. You must realize that plastic surgeons specialize in wound care, not PCPs.   I believe your plastic surgeon is more than qualified to handle your arm wounds.  In my practice, I would apply a cream called Santyl. Santyl is an enzymatic debriding agent. Santyl will remove the yellow tissue in the wound. Once the yellow tissue is gone, I stop the Santyl.  Then, I apply either Granulex spray or bacitracin ointment. These wounds may take 2 to 3 weeks to close. At this time, if all the other incisions are closed, I would encourage showering with soap and water. Showering will help to keep these wounds clean.  If you have any further questions regarding post operative care after an arm lift, arm reduction, or brachioplasty, please contact my offfice.  Sincerely, Dr. Katzen.

Ira H. Rex lll, MD · Answer

This type of wound is very common after brachioplasty. In your photographs, some necrotic tissue is present. This should be cut away. The body has a wonderful capacity to heal wounds like this using a variety of treatments. I prefer having the patient wash the area with soapy water, rinse well, then place a dry dressing. Wounds like this often keep themselves somewhat moist. You should let your plastic surgeon know what's going on and follow their direction.

Robert L. Steely, MD, FACS · Answer

Good morning!Sorry to hear of your postoperative issues.  Poor wound healing is unfortunately relatively common after a brachioplasty- the suture line undergoes a lot of stress and strain throughout the day.  Your wound is pretty significant- but nothing that will not heal with local wound care and time.It is always best to follow your surgeons suggestions, but if you were my patient I would perform a local debridement of the necrotic tissue followed by thrice daily washings and coverage with a light layer of antibiotic ointment and a soft gauze pad. will take several weeks to fully close and you may need a small scar revision months afterward.I hope this helps

Nelson Castillo, MD · Answer

Thank you for your question and for sharing your photographs.  I am sorry to see your wound separation and would reach out to your surgeon to ensure appropriate wound care recommendations.  Though no infection is apparent you may require wet to dry dressing changes for debridement until nonadherent gauze and appropriate ointment coverage of the wound will complete healing.  Hope this helps.

Steven Varkony, MD · Answer

Congratulations on your recent procedure. These incisions are fairly new and do take time to heal, I recommend you follow up with your surgeon and have him/her closely monitor the incision site.

David Rosenstein, MD · Answer

hisorry for this small problemit will heali would recommend to my patients, soap and water wash with an antibacterial soap 2-3 times a day, the axilla is kind of dirty.also the wash will remove the junky looking stuffthen aquaphor healing ointment to keep it moistlimit arm activity if possible,ie. over head it may take time but if you are healthy and clean it will healgood luck

Vasdev Rai, MD · Answer

Open wounds need wound care to heal. See a qualified professional in your area for advice and care.  There are different ways to treat open wounds. Follow the advice that your receive from your own professional.

Tom J. Pousti, MD · Answer

Congratulations on having undergone the arm lifting procedure. These types of superficial separations may take a few weeks to heal. Close followup with your your plastic surgeon will be important; for example, he/she may be able to help you with exposed sutures and/or removal of unhealthy tissue. This type of local wound care may help expedite the healing process. Best wishes for outcome that you will be pleased with long-term.

Samir Shureih, MD · Answer

Based on the pictures posted, the open wound has some necrotic tissue that needs surgical debridement. Followed by appropriate wound care. Dryness is not good for wound healing and vasiline is not appropriate wound care

Armpit open wound after brachioplasty. Any suggestions? (photo)

Answers (9)