Swelling After Bilateral Brachioplasty

Question

Hello, I have swelling in my elbow joint which has started 6 days post brachioplasty, only in my left arm. Is this normal? Thanks

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding swelling after a brachioplasty or arm lift.
Swelling is common, if not expected, after a brachioplasty or arm lift. There are several maneuvers that I employ to minimize upper extremity swelling or edema. I have my patients wear an ACE bandage from the fingers to the armpit for seven days. If there is no forearm swelling after seven days, I have my patients discontinue the ACE bandage from the fingers to the elbow, but continue wearing the ACE bandage from the elbow to the armpit for another seven days. If my patients continue to have swelling in the forearm after the first seven days, I have them continue wearing the ACE bandage from the fingers to the elbows. In addition, I have my patients keep their elbow straight and their hands elevated above their heart. This can be accomplished by placing two or three pillows underneath the elbows at all times. I also have patients open and close their hands 15 to 20 times an hour to minimize hand edema. 
Once the arm incision is healed completely, arm compression is essential to minimize swelling and to help flatten the scar.  To minimize scarring after a brachioplasty, I have my patients wear arm compression for 4 to 6 weeks. Therefore, swelling after a brachioplasty is expected. However, just to be safe, you should express your concerns to your board-certified plastic surgeon.
Good luck with your healing from your brachioplasty.    
If you have any questions, please do not hesitate to contact my office.  
Sincerely, Dr. Katzen

Jamil Ahmad, MD · Answer

Recovery after body contouring surgery takes some time, typically 6 months for most of the swelling to resolve and over a year for the scars to mature. Brachioplasty is no exception. At 6 days after brachioplasty, you are still very early in your recovery. Swelling of the elbows can occur after brachioplasty in the early postoperative period. This should slowly decrease significantly in the first 6 weeks following surgery. If liposuction was used to help contour your arms, then you will typically experience even more swelling and this will also take time to resolve. Be sure to communicate your concerns with your surgeon and follow the postoperative instructions.

Richard J. Bruneteau, MD · Answer

It’s
not unusual for patients to develop swelling following brachioplasty. The
swelling may occur for a variety of reasons, but is usually always transcient
in nature.

Occasionally,
patients develop localized unilateral swelling of the arm. When this occurs,
other causes should be considered including seroma and hematoma formation. When
these conditions occur, drainage is often indicated.

For
these reasons, it’s important that you discuss this problem with your plastic
surgeon so appropriate intervention can be undertaken if necessary. When this occurs results
are usually excellent, but failure to address these issues can result in
complications including wound breakdown.

Sarah Mess, MD · Answer

Follow up with your surgeon, you probably have a seroma or fluid collection under the skin. The surgeon will drain the seroma with a needle. Most patients are still numb near the incision and feel relieved when the fluid is drained. Continue to follow up closely with your surgeon, the seroma may require repeat drainage.

Thomas Fiala, MD, FACS, FRCSC · Answer

Hi.  your swelling is probably just normal, expected post-operative swelling.

	It could also possibly be a fluid collection (seroma or hematoma), which might require treatment.  Your surgeon should take a look at it, just to make sure...

	 

	All the best,

Jeffrey M. Darrow, MD · Answer

Swelling after any surgery is normal but it should be symmetrical on each side. Localized swelling at the elbow is likely due to a blood or fluid collection from the surgery. These are best and easily treated by aspirating the fluid with a needle in the office. This may need to be done a few times to get full resolution. Elevation of the arms and mild compressive dressings over the site can help speed the correction. Make sure your surgeon is aware of the problem and your concern about it.

Otto Joseph Placik, MD · Answer

Generally this is normal due to the interruptuon in lymphaticovenous circulation due to the tourniquet like effect of the scar. However, there are other ptoential more serious causes which should be evaluated by your surgeon.

Jason Hess, MD · Answer

blingblingmands,

	Swelling 6 days following nearly any procedure is normal.  Be sure to keep close follow up with your plastic surgeon.  If you have any concerns, call him/her and schedule early follow up.  Most swelling is normal, but on rare occasion, it can be an early sign of infection or seroma.

Tom J. Pousti, MD · Answer

Thank you for the question.

	Some degree of swelling around the elbow is very normal after brachioplasty surgeries.  However, if you have significant asymmetrical swelling this may be of more concern. Also if you truly have swelling in the elbow joint itself this would be of concern as well.

	It is always best for patients to be seen by their operating plastic surgeon with any signs or symptoms of concern.

	I hope this helps.

Steven Turkeltaub, MD · Answer

Swelling after a brachioplasty is quite normal and can even be asymmetric which can be related to activities or even positioning. However, it can also represent a fluid collection. Therefore, you should contact your plastic surgeon and have him/her assess the situation.

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