Lifting Arms (Brachioplasty)
The lifting of the arms, also known as brachioplasty, is an operation to reduce the amount of flaccid skin of the arm, and when appropriate the fat, often referred to as “bat wing.” This is more common after weight loss and can result in sagging skin that can not be improved through regular physical activity and a healthy and balanced diet.
Preparing to intervention
The surgery should not be performed in pregnant patients or nursing.
They should not be taken for two weeks prior to surgery or medications containing aspirin or acetylsalicylic acid, as well as taking oral anticoagulants should be adequately replaced with low molecular weight heparins agreeing everything with the patient’s GP. A month before the ‘intervention must be suspended progestogen therapy (birth control pills) in patients who use it: this to further decrease the risk of deep vein thrombosis in the legs.
If you smoke, you should stop for at least one month before surgery to reduce the chance of post-operative complications.
And it recommended getting right now a mesh tubular elastic compression.
The night before must be done carefully cleaning shower, shaved with a razor completely the axillary region, removed the nail polish for hands and feet.
Observe the fast of at least 8 hours before the ‘intervention.
The brachioplasty surgery is performed under local anesthesia with sedation or general anesthesia depending on the case, and usually stays in the hospital for one or two nights. It lasts for 2 to 3 hours depending of the ‘extent of the reduction and the technique used.
During the operation, Dr. Grassetti creates an incision on the inner surface of the arm, sometimes up to armpit, starting from above the elbow. The skin and excess fat are removed and the remaining skin is redistributed.
At the end of ‘intervention it is placed a drain for each operated side, a armpit level, which will be removed after 12-36h.
You may feel a slight pain: often coincides with the species tightness lifting the arms. It is easily kept at bay with standard analgesics and in any case will regress within a few days. If the pain may arise suddenly and accompanied by sudden swelling you must immediately inform your surgeon for a possible development of hematoma.
During the first week and sometimes ten days, they will develop swelling and bruising not only at the level of the arms, but also to the armpits and chest by gravity. They are physiological and subside spontaneously. Similarly, data may lead to hardening of scar tissue, that are fixed too ‘them within two months.
The sutures are removed after 10-15 days. At this point it will be possible to perform the first shower (not the bathroom!)
You must wear a jersey tubular elastic compression day and night in the 4 weeks after surgery to support the tissues while the remodeled arms they settle into their new shape and to decrease the risk of complications.
For the first 4 days after the ‘intervention is recommended rest of the biceps muscles: do not force the arms to get out of bed, do not lift weights, do not make large movements with his arms by not raising the elbows over the shoulder height. At night it is recommended to keep the arms positioned on a pillow.
For the first 2 weeks it is not allowed to drive.
For the first 10 days it will be recommended instead a home resting, always avoiding efforts to biceps muscles, performing instead walks also to ‘open air.
L ‘work can be resumed after 10 days, except in case of major manual effort.
For about a month it should be avoided any type of sports activity, smoking and exposure to sun or heat (sauna, sun lamps, etc.).
For a few months there will be some reduction in skin sensitivity on the area treated.
POTENTIAL COMPLICATIONS GENERAL
As with any surgery, albeit modest and performed on patients in good health, you may encounter:
A modest bleeding wound is normal. If important entities may require surgical reintervention.
wound infection. It is manifested by pain, swelling, warmth and redness of the skin, whether or not accompanied by fever. Any infection can usually be treated with antibiotics and local wound dressings, but may result in poor quality scars.
The appearance of a hematoma in the first hours after the surgery is rare and is treated with immediate or suction drainage (whence the ‘importance of the positioning of a safety drainage). However, it can occur up to a week after surgery. It is manifested by severe pain and sudden increase in volume and hardness of the arm that should be reported immediately to the surgeon, as well as bruising on the overlying skin in the following days. If modest it reabsorbed spontaneously. If larger may require the evacuation including by reopening the wound in the operating room.
The formation of seromas consists in accumulation of a yellow and transparent liquid called serum, entirely similar to that which forms in blisters and bubbles of burn victims. Small amounts are absorbed spontaneously, while gathered more conspicuous that should form when the drains are no longer present may require ‘aspiration or surgical drainage as in the case of major hematoma.
Dehiscence (reopening) of the wound is very rare. Usually it heals spontaneously with outpatient medication; more rarely it may require a new suture. And ‘more common in diabetics, smokers and obese.
Although very rare, phlebitis and pulmonary embolism: the ‘incidence increases if the patient is not mobilized early.
POTENTIAL COMPLICATIONS SPECIFICATIONS
Necrosis and subsequent ulceration of the skin. It ‘a very rare circumstance, but fearsome and due mostly to problems not reported at the time of the visit or to patients who smoke heavily or very large arms and perishable. It can also result in a remote surgical treatment to revise the scar.
Necrosis of part of the adipose tissue (liponecrosi) can manifest with early leakage of oily liquid from the wound, or at a distance of time with possible formation of fibrous nodules, indurations, calcifications or depressions of the surface, often asymptomatic.
Nerve injuries: sever picole sensitive nerve endings is inevitable during action for a few months and involves reduction in sensitivity in’ area treated. The corruption of larger nerve fibers instead, Sebben rather rare, can result in much more prolonged anesthesia (12 months) and sometimes permanent.
Asymmetry of the profile between the two arms: the skin elastic tone, fatty deposits, bony prominence, and muscle tone may contribute to it. It should also be said that a perfect symmetry in the volume of arms is realistically impossible to obtain.
Undulations on the skin small claims are quite common.
Lymphedema. It is a posthumous swelling in the upper limbs due to lymphatic vessel section. It is usually transient and resolved with lindo-draining massages.
The improvement effect is immediately evident, giving back thin and toned arms, although the final result should be evaluated after six months, as well as any “tweaks”. It must be said that the Brachioplasty does not stop the normal aging process, so it is inevitable that with age the skin relax or determine a new increase in size with weight gain. However, even without subsequent retouching, the appearance of your arms will still be better than you would if the ‘intervention had not been executed!
Inevitably the ‘intervention produces permanent scarring of the extension of which depends on the amount and the site of tissue to be removed, but that improve over time. Brachioplasty small claims only involve a scar in the axillary fold. If instead the more extensive scar extends longitudinally on the inner rear surface of the arm up to the elbow and, in large obese, up to the chest. They may also be evident when the patient raises his arms above his head. In addition some patients, due to excessive skin reactivity can develop reddened scars, enlarged or hypertrophic and therefore easily visible. They are treatable by surgery or require revision surgery after one year.