BRACHIOPLASTY
SURGICAL TECHNIQUES: Arm reduction surgery requires an excision, which generally extends from must below the underarm to the elbow. Excessive skin and underlying fatty tissue are then excised and the incision is closed with multiple layers of sutures. The stitches may be absorbable or may require removal in 7-14 days. The incision is placed so that it is not obvious in short sleeve clothing, but the surgical scar will remain visible permanently. Initially the scar may be red or purplish and quite obvious. As the scar matures over the first 6-12 months, the scar will fade. It is typical for incisions in this area to spread as they mature. Usually the procedure is performed with the patient under general anesthesia, although in some circumstances, the surgeon may recommend a combination of intravenous sedation and local anesthesia. Physical exercise is restricted in the upper body and arms for 2-4 weeks following surgery. It is recommended that you take one week off from work, although this may be flexible depending upon the physical requirements of your employment. You can participate visible bruising for 7-14 days following surgery and some degree of residual swelling for weeks following surgery. Your surgeon may ask that you wrap your arms in ace bandages or some
other compression garment for several weeks following surgery. Blood transfusion is usually not required.
RISKS AND COMPLICATIONS: The most common complication following this surgery is a collection of blood or tissue fluid beneath the incision. If this produces swelling, tension and pain in the area of this surgery, a small second procedure may be required to remove the fluid. The incision, as noted previously, will heal with a scar and in some patients the scar may be thickened, red, or widened. Occasionally, secondary scar revisions may e required to improve the appearance of the scar, but there is no procedure to completely “remove” the scar. Contour irregularity, small bulges, wrinkles in the skin, dimpling, or overall disproportion of the circumference of the arm may be apparent after surgery. Small secondary procedures may help improve this, but such changes may be permanent. There may be delayed or incomplete wound healing, which may require special dressing or secondary surgical procedures. In very rare instances, superficial numbness, surrounding the incision or even extending into the lower forearm, may exist after surgery. This is usually temporary but in some cases may be permanent.
Even though the risks and complications cited above occur infrequently, they are the ones that are peculiar to the operations or of the greatest concern-other complications and risks can occur but are even more uncommon. Any and all of the risks and complications may result in: Additional surgery, hospitalization, time off work, or expense to you.
The practice of medicine and surgery is not an exact science, although good results are expected, there can be NO guarantee nor warranty, expressed or implied by anyone as to the results that may be obtained. Many factors beyond the control of the surgeon affect both short and long-term outcome, including but not limed to each patient’s individual tendencies toward scarring, skin quality, genetic makeup, and other health factors. On occasion secondary surgeries may be indicated or desired to obtain the optimal result. If such procedures are performed, there may be additional charges incurred by you.
COMMENTS: If you are a smoker, you must be off cigarettes for two weeks before surgery and for two weeks after surgery. Smokers have a much greater risk for scarring, poor healing, hair loss, and skin loss.
You must be off all Aspirin containing products for two weeks before surgery and for two weeks after surgery. Check all medications with us. Some medications, such as Motrin and Advil, may also affect clotting. You must stop all herbal medications 2 weeks prior to surgery.
The following information is regarding arm reduction surgery, also known as brachioplasty. It is important that you review, understand a discuss with family or friends this information before choosing to proceed with surgery.
GOALS OF ARM REDUCTION: The procedure of brachioplasty is to remove excessive loose skin and underlying fat, usually from the bottoms of the upper arms. The intent of surgery is to improve the contour of the upper arms, to tighten the skin, and to improve the appearance of the upper arms in clotting. In any given patient, these goals may only be partially met.
LIMITATIONS OF THE PROCEDURE: The correction of soft tissue laxity and excessive fat is generally restricted to the immediate area of this surgical procedure. If the rest of the arm, particularly in the elbow area and forearm is also heavy, this may be improved and the arm may still be less than ideal. Over time, the skin may stretch and some laxity may return. In addition, with significant weight gain, areas of uneven fat distribution may become apparent in the area of the surgery or immediately adjacent to it.
ALTERNATIVES TO THE PROCEDURE: In some patients, suction lipectomy may be utilized instead of direct surgical excision. However, a good result from suction-assisted lipectomy is dependent upon very good skin tone and the ability of the skin to retract or tighten following liposuction. In patients who have had considerable weight loss or have very poor skin tone for other reasons, suction lipectomy may not be indicated. Diet and exercise will reduce the amount of subcutaneous fat and may improve the heaviness of the arms but they will not generally improve severely loose skin. This procedure is of no functional benefit and is performed entirely for cosmetic reasons. Without surgery, the laxity of the skin is likely to increase with age.
