4 weeks post arm lift. Is tissue breakdown normal? (Photo)

I am 24 days post extensive arm lift. My surgeon warned there is often tissue breakdown at the "T." I have seen him about this and he states it is normal, to keep it covered in ointment (Neosporin or Vaseline) and it will heal itself over time. I trust him, but to see this on my own body is TERRIFYING and so discouraging. It is uncomfortable but not painful, no discharge and no smell. Can anyone please provide reassurance that this will heal into a normal scar, and in approx what time period?

Doctor Answers 7

4 weeks post arm lift. Is tissue breakdown normal?

I can appreciate your concerns and fear right now.  It is intimidating to see a large wound on your body, and you are probably even more upset because it happened after an elective surgery.  These things happen, and no one on this forum can definitely tell you why because we did not operate on you.  

Yes, your wounds have opened up, and right now it is acceptable to manage this conservatively.  Your surgeon may need to debride (cut out) some of the dead tissue in the office in order to help it heal.  Don't worry, the debridement shouldn't hurt if he or she is removing the dead tissue.

Excellent wound care is paramount, and will likely include regular showers and application of ointment or other wound care gauze (I really like a product called Acticoat, it is a special silver-lined gauze).  It will take some time for these to heal, somewhere on the order of 4-6 weeks, possibly longer.  Make sure you are eating well and maintaining good protein intake, this will help wound healing.  Once the wounds heal they will leave larger than normal scars because the skin edges are now separated.  This is known as healing by secondary intention -- feel free to look it up on the internet.

Be patient and follow up closely with your Plastic Surgeon.  Give it time and see how things heal up over the next few months.  Best of luck!

Post extensive arm lift

Hello Brchodzin, thank you for your question and for providing pictures. I agree with your surgeon for the use of conservative treatment of this wound. However, based on your photos, I would use an ointment called Santyl. This is an anosmatic debriding agent, which will help get rid of the yellow and accelerate the development of granulation tissue. When much of the granulation tissue develops, I would then suggest the use of Granulex spray, which will help to accelerate finial wound healing. Healing is multifactorial and depends on many things. If you are a smoker, please avoid smoking and I would encourage daily or twice daily showers with soap and water. The healing of this wound can also be sped by using a hypertrophic barring chamber.

It is very important that as this wound heals that you do not develop a scar fracture. Therefore, I would suggest aggressive arm movement to include armpit stretching and trying to raise your arm and elbow above your head. Even if your incision cracks and bleeds, it’s more important that you achieve mobility of the armpit. As to when this arm incision will heal, this totally depends on your body’s ability to heal. On average, its takes about 2-4 weeks. If you have any further questions do not hesitate to contact my office.

Sincerely,
J. Timothy Katzen, M.D.

Arm lift wound issues

Sorry to hear about your wound breakdown.  Significant openings like you have will require close contact with your surgeon and frequent visits.  In our practice we use local wound care centers and you may want to ask your surgeon if there is such a center near you.  Hang in there during this difficult time and keep your surgeon advised of all concerns you have. 

Below is a fully-healed arm lift. 

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 32 reviews

Arm lift skin. breakdown.

Arm lift repairs should never break down if a perfect result is experienced, but to be clear this has happened for all of us who think back about about our individual results.  The required care needs may take  on different forms, including daily cleaning, application of Bactroban ointment, and on rare occasion even local debridement and secondary closure.  Follow the advice of your Plastic Surgeon to finally reach an acceptable result.

Good luck to you.

Frank Rieger M.D.  Tampa Plastic Surgeon

You need immediate surgery

You have necrosis and looming fascitis infection, seek a surgeon who makes radical debridement under total anesthesia, leave the wound open and makes second and third looks at it with his knife.

Your complication is serious, can happen in such dirty place as the axilla, but you need attention asap.

Alejandro Nogueira, MD
Spain Plastic Surgeon
5.0 out of 5 stars 34 reviews

4 weeks post arm lift. Is tissue breakdown normal?

Appears as tension caused wound or incision dehiscence has occurred. Best to have close follow up with your surgeon... 

Wound care

This wound needs tremendous amount of care. Local wound care, deride meant of necrotic tissue, and may be surgery.
in my practice this wound would be seen twice weekly by the surgeon and home nursing care, dressing change maybe wound vac.
go back to your surgeon for care. Surgical care involves preop, intraop, and post care till all is healed

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.