Why This Ugly Scar After 9 Months After a Brachioplasty, Can This Be Less Visible? (photo)

                  It’s
important that patients have realistic expectations when undergoing
brachioplasty. This procedure is effective in removing excess arm skin, but
does have several limitations including the potential for severe scarring.

                  Your
pictures and history suggest that you’ve undergone a significant weight loss
and that this was accompanied by the development of
noticeable upper arm skin sag. Your pictures also demonstrate pronounced
improvement in your contour which would be considered reasonable for this type
of procedure.

                  It’s
important to understand that the arm has bone and muscle which can’t be reduced
and must have adequate coverage. Efforts to tighten the skin to much can result
in wound breakdown and scar spread. For this reason, wounds should never be
closed under too much tension.

                  In
addition, severe scarring isn’t uncommon with brachioplasty. The severity of
scarring is frequently related to the patient’s biologic wound healing
characteristics. Unfortunately when this occurs scars on the upper arm aren’t
easily hidden.

                  Wound
healing continues for 12 to 18 months following this type of procedure. Your
scars appear to be red and at nine months will still have the potential to
improve. Massage, silastic and topical agents can be utilized to minimize
scarring, but if they aren’t effective scar revision may be necessary.

                  It’s
important that you discuss these issues with your plastic surgeon. It’s also
important to realize that the healing process takes time and that this type of
surgery always involves a series of trade- offs. 

Thank you for your question and photos.

First of all, you should be congratulated on losing so much weight.  Armlifting surgery does assist with removal of excess skin and fat of the arms but there is a tradeoff (meaning the scar).  Scars can be revised to try to achieve a finer line but I suggest that patients wait at least 1 year post op before proceeding with scar revision surgery.  The scar will continue to heal 12-18 months after surgery, it will continue to improve and lighten in color.  If after 12-18 months you are still unhappy with the scar, have a conversation with your surgeon in regards to the scar revision surgery.

Best Wishes!