Should I get another scar revision? Options? (photos)

Brachioplasty scars are frequently bad because of the thinness of the skin in this area, the tightness of closure, and the surgical difficulty of making a precise and accurate closure. It is tedious and time consuming to do right, and surgeons who sweat the details are frequently rewarded with still-crappy scars (now there's a medical term we can all recognize!), even after revision.However, poor technique will almost always yield bad scars. I'm not saying your surgeon did a poor job, but I do know that another scar revision by the same surgeon who did your second procedure is probably not a good plan. It could simply be how your skin heals in that location on your body, or it could be the (lack of) quality of the closure, or a combination of both. But you see where this is going. You can't change your skin or how it genetically heals, only the quality and precision of the closure, the suture materials chosen, and the technique. Then the post-operative management should be pro-active not reactive. Start silicone sheeting after two weeks and use it at least 12 hours per day. Paint-on medications are essentiallh worthless. Good luck and best wishes! Dr. Tholen

Thank you for your question about whether you should get an arm scar revision. Since you have not succeeded in arming scar surgeries, I suggest you now seek a different alternative. I would suggest you embark upon laser scar treatment; the scar laser I would suggest would be a Fraxel. A Fraxel laser helps to smooth the scar.
The little points at the end of your elbows are dog ears. These can only be remedied with surgical excision. This may require a little revision in the office where the excision is carried down the elbow and the dog ear is directly removed for the rest of the scar. My vote is the Fraxel laser.

Depending on how hard the scar is, I may treat my patients with some kenalog steroid injections directly to the scar. This can soften the scar and reduce the swelled appearance. I recommend asking your doctor if kenalog will help.If a patient still has issues with hypertrophic scarring at least 3 months after surgery, we use a combination of Micro Needling and Growth Factor Serum to reduce the thickness of the scars. Our licensed aesthetician performs the treatments in our office. Typically 3-4 treatments are recommended about 4 weeks apart. Our patients have seen nice improvement with both of these options and we also have them use a silicone based scar gel at home. The best to be achieved is to flatten the scar and decrease the pigmentation. Pigmentation can resolve on its own, but it can take several months. I would not recommend doing another surgical scar revision, as it is most certainly going to produce the same result.I wish you the best of luck!Reza Rod, M.D.

Thank you for your question and photos.  Unfortunately, the scars after an arm lift are one of the biggest downsides to the procedure.  Please keep in mind that everyone scars differently and that it can take a year for the scars to mature  I recommend following up with your operating surgeon to ensure that you are doing everything possible to treat your scars.All the best,Dr. ResultsMiami, FL

Often the most difficult for patients who perform this procedure are the scars. Over the years some scars are fading or it have an aspect of strech mark, but it depends on each patient. Sometimes you can make a correction scar, but only in cases where the patient is candidate. I think the best is ask your doctor about your options.

Hi,Thank you for your inquiry and for providing photos. The scars from brachioplasty surgery are one of the limitations of the procedure. One way to think of it is that you are trading an improved arm shape for a scar. Having said that, we strive to make the scars as thin and inconspicuous as possible. One thing we do for our brachioplasty patients is place the EMBRACE dressing along the incisions for several months post-op. This is a tension-loaded silicone sticker that helps the wound heal with less tension, and often really helps these scars look better and mature/soften faster. Ask your surgeon about it. I like this dressing on the arms, because it's a nice, flat, hairless area and the dressing sticks well. It's worth a try for you.Best of luck,Dr. Weintraub

Thanks for including photos. After your first surgery (original brachioplasty) it's more common to have scar issues because these incisions are closed under some tension and have a tendency to widen, however after a scar revision, that's a lot less common. It does look like some of your incisions have not only widened but formed hypertropic scars. While another scar revision can potentially improve the appearance of your scars, it can also make things worse than they currently are. Given you are 7 months out from the revision, I would recommend waiting some more time before another revision, and try other means to fade your scars in the meantime such as silicone gel/sheeting or massage. If you do choose to undergo another revision, your post-op activity restrictions will of course be determined by your surgeon, but I would recommend at least 6-8 weeks off from heavy arm activities, as movement of your arms is a factor in causing wider or hypertrophic scars. 

Sadly scarring is determined more by your genes than by the surgery, pills or potions. If you have made bad scars on 2 occasions you will probably find that a third attempt will produce similar scars. I would not spend more money on surgery for your arm scars. I would allow time to fade the scars as they mature. Hopefully after a couple of years they will be less noticeable.Some people have success with camouflage cosmetics to cover the scar. Some of these can be waterproof.I am sorry I can not offer you a magic solution!Good luck.

Thank you for your question and photos.  While a brachioplasty can significantly improve the contour of your upper arms, it can leave very prominent and unsightly scars.  Scars can take up to a year to mature and soften.  To lessen the prominence of scar after surgery, silicone-gel sheeting, fractional laser treatments, and other scar management treatments have been shown to effective.  Discuss with your plastic surgeon the possibilities of using these modalities.

Thank you for your question and photos.  I'm sorry to hear about the issue with your scars.  Unfortunately, the scars for an arm lift are notorious for being some of the worse.  They tend to stretch and get wide.  In my practice, I advise my patients to wear compression garments and to restrict arm movement so not to create too much tension on the incision.  Sometimes, this can be really helpful but is no guarantee.  There are other variables like your genetic predisposition for scar healing.  There are some nonsurgical treatments such as silicone sheeting and steroid injections to help soften the scar.  Your scar undergoes incremental changes up to 1 year.  After that, you have the opportunity to consider scar revision.  Best of luck.