Do I need a scar revision after Brachioplasty? So red and wide! (Photos)

Question

I had brachioplasty a 12 weeks ago and my scars have gotten wider and redder as time goes on. I did have major arm lipo with the brachioplasty. Compressed them with tensors for 6 weeks and I keep out of the sun. I just feel the scar is very jagged and scary looking. I feel super self conscience about it. Should I get laser or other scar therapies or get the scar revised?

Kenneth Hughes, MD · Answer

Arm lift scars take longer to heal just try to be patient, but this can take up to 1 year continue to follow up with your PS

J. Timothy Katzen, MD, FACS · Answer

Thank you for your questions regarding arm lift or brachioplasty scar revision. It appears from your history, all the correct post-operative instructions were followed. Nonetheless, you have thick red, raised, arm lift scars. Your arm lift scars do not appear to be keloids, but rather just thick, red, arm lift scars. Since you are three months from your arm lift, I would suggest surgical arm scar revision. I would not waste your time and money on lasers and other scar treatment. Typically, I perform arm lift scar revisions in my office under local anesthesia. I usually perform one arm lift scar revision at a time. This way you can use your other arm during your recovery. I usually perform the other arm lift scar revision approximately one to two months after the first arm lift scar revision. Arm lift scar surgical revisions are extremely successful. It is exceedingly rare to have to touch up arm lift scar revision scars. In your case, the widen arm lift scar may be due to the "major arm lipo" you described for your procedure. When seeking an arm lift, please seek an experienced, board-certified plastic surgeon who has done hundreds of arm lifts in their career. Examine their before and after pictures closely to examine the quality of their work. If you have any more questions regarding the arm lift arm reduction or brachioplasty, please contact my office. 
  
Sincerely, Dr. Katzen

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Reza Rod, MD · Answer

You're not alone in wanting to do something about your scars.  Many patients feel the same way about their arm lift scars.  Although plastic surgeons try their best to make scars as small as possible, the arms are especially difficult.  A great deal of skin and tissue is removed in this procedure.  Just consider the size of skin that is removed in portion to the size of the area!You're already doing the right things with taking care of your scars.  Keep applying your, sunblock, scar cream, and they will lighten.  Start at lower invasive treatments like micro needling and laser treatments before getting a scar reduction surgery.  If I had to guess, I think you'll likely end up getting a scar revision procedure but you should give these other procedures a chance while you wait.  I'm sorry it takes so long to lighten scars but you're on the right track!

Clayton Crantford, MD · Answer

Thank you for your question. The only way to decrease the width of your scars is to undergo a scar revision. Typically scar revisions are not performed until at least 6 months postop. The redness will fade over time, but there are plenty of scar management options such as silicone sheeting and multiple creams that may speed this process up. Laser can also be used to help the redness fade. I reccomend you follow up with your surgeon to discuss your options.

Ira H. Rex III, MD · Answer

Unfortunately, it is not unusual to see scars like yours after this particular procedure. You are still very early in the healing phase and your scar may go on to turn flesh colored and be quite acceptable. For now, you would do well to start silicone gel topical therapy for about a 12 week course. This is probably your best bet for improving the appearance of the scar.

Alexander M. Sailon, MD · Answer

Hi mommydoll,
Arm lifts can create unsightly scars, even in the best surgeons' hands. The good news is that the redness you see will likely fade over the next year. I would recommend beginning scar therapy with a silicone based product (either gel, cream or strips) if you have not already. In addition, you can consider laser to take away some of the redness. Nothing will have much of an impact on the scar width, however. Talk these options over with your plastic surgeon.

Tracy Kayan, MD · Answer

The main issue with wound healing after a brachioplasty is that the surgery is a balance between taking out enough skin to treat the issue at hand and not taking so much that there is tension on the wound and a widened/red scar. You are still very early out from your surgery. At this point, topical treatments such as scar gel or silicone sheeting may help fade out your scars faster, but it will not affect the wideness. Some patients choose to undergo laser treatment to their scars for redness or pigmentation, but unless you undergo a scar revision, you will never have thinner scars. If you do nothing, they are very likely to fade and become less visible over time. If you do choose a scar revision, you should not do this until at least 9-12 mos out from your original surgery, and you always do risk ending up with another widened scar.

Justin Perron, MBBS, FRACS · Answer

Thanks for your question regarding your post-op scar. Scars can vary significantly from person to person. This can be due to location of the scar, genetics, post-op complications such as infection, reaction to the suture material being used, and the type of surgery performed. Typically, most scars can be treated through the use of silicone containing gels or sheets, massage and in some circumstances, steroids. Specific types of lasers have an application in the treatment of scars, and can be used to address the redness. Have a talk with your treating surgeon, and they can recommend a treatment that will work best for you.
Good luck!

Gary L. Ross, MBChB, FRCS · Answer

Arm lift scars are renowned for being red and unsightly at this time and massage is very important. Keep them out of the sun and apply sun factor. Ask your PS about the various options of scar management and to show you how to massage. This will improve.

Do I need a scar revision after Brachioplasty? So red and wide! (Photos)

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