Is it possible to have a arm lift after node biopsy and mastectomy?

Question

I had a sentinel node biopsy. Two lymph nodes were removed with the surgery. The first one positive. I also have had radiation and SGAP reconstruction to the breast. I suffer no symptoms of edema in my arm. Would having radiation rule out the possibility?

J. Timothy Katzen, MD, FACS · Answer

Hello DeLany E. in Seattle, WA, 
Thank you for your question regarding is it possible to have a arm lift after node biopsy and mastectomy.  Thank you for your history.  Since you have no symptoms like edema or swelling in the affected arm, most plastic surgeons would agree that you can undergo an arm lift or brachioplasty after axillary sentinel node biopsy, mastectomy, radiation, and SGAP breast reconstruction.  Radiation can alter blood flow and cause scar tissue, but it should not deny you the ability to undergo an arm lift.  During a routine arm lift (arm reduction,brachioplasty) procedure, the axillary nodes are not altered or damaged.  During a “standard” brachioplasty, an incision is made from the axillae to the elbow, and a large elliptical area of excess skin and fat is removed.  Arm liposuction may also be performed.   
I hope I have answered your questions regarding arm reduction and, specifically, whether it is possible to have an arm lift after a node biopsy and mastectomy.  If you have any more questions regarding the arm lift, arm reduction, brachioplasty, arm scar revision, or arm crease fat grafting, contact an experienced plastic surgeon.  To get an accurate assessment of what exactly you need, schedule a free virtual consultation.  Most plastic surgeons offer free virtual consultations.  Since an arm lift can be a challenging surgery, please seek an experienced, board-certified plastic surgeon with extensive experience performing these lifts.  Do your research.  Make sure they have performed at least 150 arm lift procedures.  Make sure they have the before-and-after pictures to prove it.  Carefully examine their before-and-after pictures and check their reviews on RealSelf.   Sincerely, Dr. Katzen, MD, MBA, FACS, FICS ( 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.)

Young R. Cho, MD, PhD · Answer

Thank you for your question and for sharing your experience with us. An arm lift procedure is fairly invasive and will disrupt some of the lymphatics of the arms. I would recommend that you visit with a board-certified plastic surgeon who can examine you and discuss the potential risks and benefits with you in more detail. The biggest risk that you may encounter is lymphedema after the procedure.  However, you have only had two nodes removed. The radiation therapy, also will increase your risk of lymphedema, particularly if it was also directed towards your axilla.

Aldo Guerra, MD · Answer

Hello DeLany E. Thanks for your question. I believe you are still a candidate for arm lift surgery, but I would have to see you to confirm this conclusion. Because you have most of your lymph notes intact in the axilla, theoretically, you should be at lower risks of lymphedema when compared to someone after full axillary dissection. However, you will be at higher risks when compared to someone with no dissection and/or radiation treatments. A conservative arm lift on that side (not too tight) and prolonged compression might help to get a better result for you. I would also avoid an anterior incision over the blood vessels (and lymph) and prefer to go with a posterior incision in the back of the arms (see samples on my website). Best wishes, Dr. ALDO.

Jesus M. Abreu Monttero, MD · Answer

Hello DeLanyI do not recommend you undergo this type of procedure due to your medical history. You are considered a high risk patient due to the potential healing problems and the high probability of developing lymphedema.I hope this information is useful. Please feel free to contact me in case you have any additional questions.Dr. Abreu

Anureet K. Bajaj, MD, FACS · Answer

Unfortunately, there isn't an easy answer to your question.  Since you have had two lymph nodes removed and have had radiation to the chest wall, you are definitely at high risk following an arm lift (brachioplasty).  The potential issues may be wound healing problems and the development  of lymphedema.  However, since you do not have lymphedema now and only had 2 lymph nodes removed, you may be a candidate for a more conservative arm lift.  I would suggest that you consult with a board certified plastic surgeon to discuss your options and good luck!

Is it possible to have a arm lift after node biopsy and mastectomy?

Answers (5)

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