Brachioplasty Boston | Taylor & Sullivan Plastic Surgery Boston

Frequently Asked Questions

Am I a candidate for a brachioplasty?

The ideal patient for a brachioplasty is someone whose upper arms have significant extra skin, and are disproportionate to their lower arms. Brachioplasty is not a good treatment for extra fatty tissue in the arm. The ideal patient should be at their lowest realistic weight, and in good health. Smoking is a contraindication to surgery. Because the scars of many brachioplasties are visible, patients must be willing to trade shape for scar. During your consultation, we will discuss your aesthetic desires and determine the course of action which is safest, and best suited to achieve your goals.

What are the results of an arm lift?

For many patients the removal of the extra arm skin provides tremendous relief. Not only do they look and feel better, they have improved mobility of their arms, and a wider array of clothing choices. Scars are inevitable, but it is difficult to predict how visible they will be, as everyone scars differently. Short term problems with wound healing are common, particularly in the armpit, but with simple wound care heal on their own. Some patients can experience numbness, though this is rare. Brachioplasy corrects the disproportion between the upper and lower arm, by removing extra skin. It is not a weight loss procedure, or particularly good at removing fat. As such, it cannot give someone incredibly thin arms if they have bigger arms to begin with. But for many patients it provides tremendous relief.

Will there be a scar with a brachioplasty?

Yes. While all body contouring procedures involve trading shape for scar, in this case the scars can be more visible. For a limited brachioplasty, the scars are typically well concealed in the armpit. But for patients who require extensive skin resection the scar can run across the armpit and down the inner arm to or below the elbow. We try to keep the scar close to the natural groove on the inner arm, so that with arms at the side the scars are not very visible. Each patient may have slight differences in shape that dictate the positioning of the scar. While almost all scars fade over time, they will always be there. We will spend significant time deciding with you whether this is a good trade in your situation. For some patients a minimal improvement in shape may not be worth the scar, and we may talk you out of surgery. For others, where we anticipate a dramatic improvement in shape, it may be worth it to the patient to accept the scar.

What is the recovery with an arm lift?

The surgery is performed as a day surgery under general anesthetic and takes 2-4 hours. Boston brachioplasty specialists, Dr Sullivan and Dr Taylor typically work together to expedite your care. We use lots of long acting numbing medicine which significantly reduces post operative pain. We will place you in a compressive dressing after surgery, and while you may have drains, we typically avoid them. The incisions are closed with dissolving stitches beneath the skin, and dressed with a surgical glue so you can shower within a day or two of surgery. The limited mobility in the arms is often what bothers people the most. For the first 1-2 weeks you won’t want to do anything strenuous with your arms. We encourage early ambulation, and arm elevation when possible. You will remain in a compressive dressing for several weeks. We typically like to see you within a few days of surgery to monitor your progress. Minor issues with wound healing, particularly in the armpit, are common, and often show up 1-3 weeks after surgery. These heal with simple wound care. The scars may take a full year or two to fully mature, and are likely to be pink and firm within the first few months. By 5 or 6 weeks if everything looks well healed you can go back to your usual activities.

ARM LIFT (BRACHIOPLASTY) AFTERCARE INSTRUCTIONS

Preoperatively, in the week before your arm lift operation:

Consider eating pineapple, it may help reduce bruising
Consider supplementing with Arnica montana, it may help reduce bruising
Complete household chores and prepare meals for the first few days of postoperative recovery
Follow preoperative instructions with eating, drinking, and medications
Order two compression garments specific to your size. The garments do not need to be expensive. Dr. Taylor and Dr. Sullivan can make some recommendations of garments that can be ordered online.

Postoperatively, after your arm lift operation:

You will need someone to take you home, and ideally stay with you for the first 24-48 hours, as you may feel drowsy. You may require help the first few times you get out of bed.
It is important to get out of bed and walk (with assistance) every few hours after your male breast reduction operation, while awake, to decrease the chance of postoperative problems such as blood clots.
Practice 15-20 deep breaths every hour to keep your lungs open.
When in bed or sitting keep your arms elevated on two to three pillows.

Please take your medications as directed by Dr. Taylor or Dr. Sullivan to manage discomfort or symptoms following arm lift.

Acetaminophen (Tylenol) 1000 mg every 8 hours, space doses 4 hours after Ibuprofen so one or the other is taken every 4 hours
Ibuprofen (Motrin) 800 mg or Colecoxib (Celebrex) 200 mg every 8 hours, space doses 4 hours after Acetaminophen so one or the other is taken every 4 hours
Gabapentin 300 mg every 8 hours for 7 days. If you have dizziness, double vision, or significant sleep disturbances, consider stopping the Gabapentin.
Vitamin C 500 mg daily for 50 days
Oxycodone 5 mg – 1-2 tablets every 6 hours as needed for pain, though many patients may not need it
Colace 100 mg twice daily to prevent constipation, it is important to have a bowel movement each day. Prune juice may also be helpful.
Zofran 8 mg every 8 hours if needed for nausea
Scopolamine patch may be placed on the neck on the day of surgery and can stay for 3 days to prevent nausea

Eat a light diet for 2-3 days and avoid spicy food. Some suggestions to ease abdominal discomfort or indigestion after surgery:

Drink water or warm liquids
Prune juice to prevent constipation

WOUND CARE

You may or may not have drains after arm lift surgery. The drainage bulbs connected to the end of the drains should be compressed at all times to keep suction. It is normal for red fluid and blood clots to form in the drains. Please record time and amounts of drainage over a 24-hour period – we will provide a form. Usually the drains will be removed when the drainage is 30cc or less in a 24-hour period. All patients heal differently and according to many factors. On average, drains remain for a week.
You may shower or sponge bath the day after the arm lift operation with assistance and wash your skin as you normally would with soap and water. Avoid soaking the incision, although It will not hurt to get a splash of water on the wounds. Gently pat dry after washing.
Wear the arm ACE wraps or compression garments continuously for 3 weeks after arm lift surgery, then for 12 hours of each day for an additional 3 weeks, and thereafter as needed for comfort. You can take them off to shower. The first time you remove the ACE wraps or garments, please have someone help you. If you feel dizzy or light headed, sit down or lie down. The garment helps control swelling and fluid build- up. You may choose to leave them in place until you see Dr. Sullivan or Dr. Taylor for your first postoperative visit.
Most wounds after arm lift surgery will be closed with absorbable sutures that are buried and skin glue. The skin glue forms a barrier to water. Please do not remove the glue, it will fall off on its own after a few weeks. Do not apply any lotions, potions, ointments, creams or solutions (e.g. no hydrogen peroxide or alcohol) as they can be harmful to the fragile healing tissue.
Do not smoke or expose yourself to smokers or nicotine as skin and wounds can be compromised.
Infection is uncommon, though please call Dr. Taylor or Dr. Sullivan immediately at any sign of infection which would be signaled by fever, increased pain, new redness or swelling in the arms.

ACTIVITY

For the first few days following arm lift surgery, avoid raising your blood pressure or heart rate as it can cause bleeding. We recommend gentle range of motion exercises with your arms 3 to 5 times per day starting the day of the operation.
Please do not drive until turning the steering wheel can be done safely and without pain (usually 7 to 10 days). Do not drive while taking pain medications such as oxycodone.
Do not lift anything heavier than 10-20 lbs, run, lift weights, or perform strenuous exercise for 7-10 days. Do not perform arm muscle exercises for 6 weeks.
Massage can help increase circulation and soften firm areas under the skin. Please wait at least 3 to 4 weeks after arm lift surgery to start massage to avoid increased swelling.

GENERAL OUTCOMES

Moderate swelling and bruising of your arms and hands is to be expected. Please be patient. The swelling and feeling of tightness will gradually subside over the following weeks. The compression garment will help with swelling. Bruising may last for a few weeks and will move down your arms due to gravity.
It is not uncommon for a small wound to develop along the incision in the armpit. These typically appear 2 to 3 weeks after the operation, can be treated with soap and water wash and a dry gauze, and they will heal on their own in a few days to weeks.
The incisions often appear lumpy and bumpy. This is normal and the incisions will flatten over a few weeks.
Sensations like numbness, shooting pain, and burning are common during the healing process, may last several weeks, and gradually disappear. If the arms or elbow area are sensitive after arm lift surgery, it is best to desensitize them with gentle touch.
Scars and tissues take one full year to mature. You may notice that they become red, raised and firm for several weeks to months before becoming soft, flat and pale. Avoid Vitamin E as it can irritate the skin and scars. Mederma has no proven benefit and is not worth the expense. All incisions will be sensitive to sunlight during the healing phase. Direct sun exposure or tanning booths are to be avoided. Silicone cream, such as Biocorneum Advanced Scar Treatment, or skin moisturizer with sunscreen and gentle massage may be helpful.

A small amount bleeding from the arm incisions is expected. Please call our office (617-492-0620) if you have:

Continuous bleeding
Significantly more swelling on one arm when compared to the other
Worsening pain
Fever, spreading redness or irritation of the skin
Shortness of breath

It is important to be seen by Dr. Taylor or Dr. Sullivan after your male breast reduction operation. They will see you in follow-up appointments at 1 week, 3-6 months, and 1 year or as often as needed post-op. Call to schedule your appointments at Taylor & Sullivan Plastic Surgery office at (617) 492-0620 between the hours of 8:30 – 5:00 or visit our webpage at www.massplasticsurgeons.com. We are always available for postoperative concerns or emergencies and can be reached through our paging service 24 hours per day at (617) 492-0620.

Download our ARM LIFT (BRACHIOPLASTY) AFTERCARE INSTRUCTIONS

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