What Are the Options for Treatment of Bat Wings if You've Had a Mastectomy?

This is an excellent question.   And the answer depends on what was done to your lymph nodes.  If you had just 1 or 2 lymph nodes removed (i.e. sentinel lymph node biopsy), then you are likely ok to consider an arm lift.   However, if you had a full axillary lymph node dissection and/or radiation to your axilla, I would not advise an arm lift.  Why? Because if your lymphatic drainage is suboptimal from your arm, you will be at significant risk for infection, seroma, exacerbation of lymphedema.   Please ask your breast surgeon to find out what was done during your cancer treatment.  Best of luck

Prior to consideration of a brachioplasty (batwing correction), be sure to check with your surgeon about the  status of the lymph nodes.   For patients that have had a lymph node dissection, or radiation to the axilla, brachioplasty is absolutely contra-indicated.  For patients that have had a sentinel node biopsy only, brachioplasty may be a consideration.  One of the most common symptoms after mastectomy is the redundant skin along the lateral (outer) part of the chest, immediately below the armpit.  This can often be treated by liposuction or direct removal of skin.  For patients that have redundant tissue in this area as well as excess skin of their arms, a combined procedure that includes correction of this area as well as the arms can produce very dramatic results.

                  When post-mastectomy patients have excess upper arm skin it’s not unusual for them to request arm lift surgery. Redundant upper arm tissue can be especially noticeable following mastectomy and for this reason, patients are often eager to address this issue.

                  In the vast majority of post mastectomy patients, brachioplasty is an excellent surgical option. This procedure results in significant contour improvement and is associated with high satisfaction rates.

                  Unfortunately, if patients have had extensive axillary lymph node dissections, brachioplasty should be approached with caution. Under these circumstances, lymph node dissection can disrupt the lymphatic drainage of the arm and create scarring in this area. This can increase the potential for swelling, drainage, infection, wound breakdown and seroma formation. For this reason brachioplasty should be approached with caution following lymph node dissection.

                  If you’ve had a mastectomy and are considering arm lift surgery, consultation with a board certified plastic surgeon is appropriate. This surgeon should be able to make an appropriate recommendation based on your previous surgical procedure. 

There are many causes for flabby arms. Incisions can be very small or large depending on location of fat. If one has flabby arms, the best indicator of the treatment would be the elasticity of the skin.  If the skin has good elasticity, then Liposuction alone may be the answer.  If not, then an arm lift to resect the excess skin is best.  However, the best indication for an arm lift, and the most gratifying are those who have lost a lot of weight.  The skin is usually flabby and overstretched.  It is simple and effective to remove the skin that has been stretched past its capacity.  No Liposuction, or other noninvasive modalitiy will help the skin become more firm around the arms.  The length and type of the incision will vary depending upon the location and the amount of fat in the arms.  The cost will also vary by geographic locale.  Most will run anywhere from $3500-$7000.  I would advise you to visit with a board certified plastic surgeon to have treatment recommendations specific to your concerns.

Thank you for the question.

Arm lifting is an excellent procedure to improve the contour of the arms;  the downside is a relatively high rate of unsatisfactory scarring and the need for revisionary surgery.

If your mastectomy involved lymph node dissection  you would be at greater risk for significant swelling/complications after arm lifting surgery.  Arm lifting  may be contraindicated in your case. 

You may want to check with your oncologic surgeon to ask about previous lymph node surgery.

Contouring the upper arms is an extremely successful procedure.  Batwings, hanging skin from the upper arms, is removed to provide a smooth and youthful contour.  This can be performed after breast reduction or in conjunction with other body contouring procedures.  There is a long scar, but this is usually well hidden at the back of the arm.

If during the mastectomies, lymph nodes were taken, or you have any swelling of the arms, hand, lymphedema, then do not do any surgery of the arms. Consult your plastic surgeon, for complete examination, review of your medical records and a chat with your general surgeon about lymph nodes removal during the mastectomy.