Wound dehiscence after arm lift with lipo. Should I have a second opinion? What else can I do? (photos)

Question

I had arm lift on May 2nd 2019. Had right armpit open up 2 weeks post op and then my other armpit opened up 3 weeks post op. I have attached photos. PS had me treat the first wound, by packing with collagenase 2x a day for about a week and then packing it with a wet gauze (Tap water). He has me treating the left arm with collagenase still. I am very concerned and of course depressed that these wounds are so large and haven’t progressed much. Is there anything else that I can do?? Is this malpractice?

Kenneth Hughes, MD · Answer

Hello, thank you for your question. I am sorry you are having post op complications, the photos are helpful. This kind of thing does happen on occasion, with good local wound care you should heal just fine. It can take up to 4 weeks to heal in, continue following up with your plastic surgeon. 
Best of Luck.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding what to do concerning wound dehiscence after an arm lift. It appears that the arms are healing by secondary intention. This means that they will close on their own. I do not see any signs of infection and I see healthy, granulation tissue. I would apply a product called Medihoney to the area of granulation tissue that will help to close the wounds. It helps the wounds to also create new skin. The application of wet dressings at this time would not significantly help.

Wound breakdown is a common occurrence, especially in arm lifts and especially in the armpit or axillary region. This should have been outlined and explained to you even before the procedure in the preoperative surgical consents. Almost all of these wounds heal without incidences. There may be a widened scar which can usually be revised in 4-6 months in the office under local anesthesia.

In my opinion, this is not malpractice. This is just a wound that opened up and has a known potential for opening. The arm lifts open because of the anatomy of the area and sometimes difficulty in healing in weight loss patients. I hope this helps answer your question regarding wound dehiscence after an arm lift with liposuction.

Sincerely,
Dr. Katzen

David Nguyen, MD · Answer

Hi Eclectic7974,
Unfortunately, these are possible complications from an arm lift. They don't usually happen to this extent but it is always possible. Your wounds look clean and they look like they are granulating/healing in well. It's best to continue the dressing changes and follow up with your surgeon. I imagine everything will eventually heal up well. Blessings on your journey!

Matthew A. DelMauro, MD, FACS · Answer

Hello! Thank you for your question. I'm sorry that you have experienced a postsurgical complication. Unfortunately, wound dehiscence is not uncommon after this procedure. The treatment for it is local wound care. It will take time and patience before your wound dehiscence is completely healed. I hope this answers your question. 
Matthew A. DelMauro, M.D.

Leonard Tachmes, MD · Answer

Hi and welcome to our forum!
The operative procedure of arm lift involves
separation of the skin and soft tissues of the arm from underlying muscle. Excess skin and soft tissues are removed, and the tissues are advanced across the resulting defect and the incisions are closed. .
If there is impairment of the blood supply to the skin and
soft tissue, the segment of the flap the greatest distance from its blood
supply may not survive.
The cause of the blood supply impairment can range from an overly tight closure, effects
of smoking, diabetes mellitus, vascular disease, previous surgery in the
area (disrupting the normal blood supply), infection, or may totally
inapparent.  
Treatment consists of removal of the unhealthy tissue, followed by
intensive wound care. One looks for the development of granulation tissue, a
beefy red vascular tissue, to develop, after which time the wound will begin to
shrink. Most wounds of this size will seal over a span of 2-3 months.
However, a regimen of frequent wound care is required after unhealthy
tissue is removed. Every plastic surgeon has his / her own "favorite" regimen of wound care based upon years of experience. Follow your surgeon's instructions.
Your wounds are granulating quite well. 
Once, sealed, the scars will initially be quite noticeable, but the scar will mature and its appearance will improve over 6-12 months. Will revision of the scar be required? Only time will tell. .
The decision to seek a second opinion is yours to make. Complications happen. 15% of cosmetic surgeries require a secondary revision.
Continue followup with your plastic surgeon
Best wishes...

Wound dehiscence after arm lift with lipo. Should I have a second opinion? What else can I do? (photos)

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Answer: Arm Lift Complication

Answer: Arm Lift Complication

Answer: Delayed healing 6 weeks after brachioplasty / lipo

Answer: Delayed healing 6 weeks after brachioplasty / lipo

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Wound dehiscence after arm lift with lipo. Should I have a second opinion? What else can I do? (photos)

Answers (5)

Answer: Arm Lift Complication

Answer: Arm Lift Complication

Answer: Delayed healing 6 weeks after brachioplasty / lipo

Answer: Delayed healing 6 weeks after brachioplasty / lipo

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Recommended reading

Everything you need to know about Arm Lift

Our mission is to create a world where every investment in modern beauty is Worth It.