Short-term Side Effects after Brachioplasty Immediately after surgery some patients will have a feeling of tightness in the upper arm as the area swells due to the trauma of surgery. Some patients may develop swelling and some tingling of the hands as well. Most of these symptoms resolve with time.
Risks and Complications of Brachioplasty
The following complications can occur with an arm lift procedure:
– Bleeding or hematoma
– Seroma or fluid accumulation
– Phlebitis – swelling of the hands
– Delayed or poor wound healing
– Skin loss or necrosis
– Motor or sensory function
– Blood clots – deep vein thrombrosis
– Excessive or widened scars
– Skin discoloration
– Change in skin sensation – numbness
– Sensation of arm tightness
– Allergic reaction
– Anesthesia risks
Bleeding or Hematoma
– Hematoma or excessive bleeding occurring with a brachioplasty is rare, however; they can happen. If a hematoma occurs, it needs medical attention immediately and may need to be surgically drained. Excessive bleeding or a hematoma increases when the patient tends to get physically active after the surgical procedure, or if medication is taken that can contribute to thinning the blood pre and post operative. The use of post operative drains help reduce the chance of a hematoma from forming.
– The risk of infections increases through the proximity of the natural crease in the axillary area. Scars and incisions are to be kept clean and the patient needs to make sure they take all of the antibiotic prescriptions. If the infection gets bad, sometimes surgical drainage can be necessary.
Seroma or Fluid Accumulation
– Seromas are fluid collections that can arise after surgery along the incision line. Drains are used to help combat this complication. Because of the location of the lymphatic system – seromas and swelling is very common with this type of surgery. Wearing the compression sleeve garment helps to prevent a seroma.
– Phlebitis (inflammation of the vein) may result from an intravenous (into the vein) or intramuscular (into the muscle) injection. Phlebitis can result in painful swelling of the hand or arm that may be prolonged. Treatment may require medication or even hospitalization. Phlebitis can occur in the leg and thigh veins. This is extremely rare.
Delayed or Poor Wound Healing
– As in any cosmetic surgery procedure, the quality of healing is not known in advance. Immediately after the surgery, an incision can inflame or weep requiring wound healing treatments that can often be a long road. Keeping the wound clean is paramount along with the patient stopping smoking. Delayed wound healing may increase the risk of infection, extrusion, and necrosis. Depending on the type of surgery or the incision, wound healing times may vary. Smoking may interfere with the healing process. Nicotine is the root cause of the decreased blood supply in that it causes constriction of the capillaries and small blood vessels that feed the skin with its required oxygen.
Necrosis – Tissue Death and Skin Loss
– In any surgery that involves the skin, there is always the risk of skin loss secondary to compromised blood supply. Tissue death or skin loss is uncommon, but the chances of this are increased after a seroma, hematoma, or infection. While rare, significant loss of skin could require hospitalization and skin grafting.
Motor and Sensory Function
– The nerves that operate your arms/hands are located near armpit area. While very rare, those nerves could be damaged causing permanent disability and sensory changes to the affected arm or hand. An important sensory nerve (“medial antebrachial cutaneous nerve”) runs down the inside of the upper arm. It is important for the surgeon to avoid injuring this nerve, which might cause a painful neuroma.
Deep Venous Thrombosis – Cardiac and Pulmonary Complications
– Surgery, especially longer procedures may be associated with the formation of blood clots in the venous system. Pulmonary complications may occur secondarily to both blood cloths (pulmonary emboli), fat deposits (fat emboli) or partial collapse of the lungs after general anesthesia. Pulmonary and fat emboli can be life threatening or fatal in some circumstances.
– Air travel, inactivity and other conditions can increase the incidence of blood clots traveling to the lungs – which can be life threatening.
Make sure you discuss with your surgeon any past history of blood clots, swollen legs or the use of high estrogen birth control pills or hormone replacement therapy which can contribute to this condition. Cardiac complications are a risk with any surgery and anesthesia – even with a patient without symptoms.
If you experience of the following symptoms contact medical attention immediately: – shortness of breath
– chest pains
– unusual heart beats
Excessive or Widen Scars – Hypertrophic or Keloid Scars
– All surgery leaves scars, some more visible than others. Although good wound healing after a surgical procedure is expected, abnormal scars may occur within the skin and the deeper tissues. Scars can become hypertrophic or possibly keloid, which can be unattractive. Scar appearance may also vary within the same scar, such as “bunching” due to the amount of excess skin. Scars may be asymmetrical (appear different between the right and the left side of the body). Also, there is the possibility of visible marks in the skin from sutures. In some cases a scar revision may be necessary. With the brachioplasty procedure, patients are made aware that they are trading one problem of loose and lax skin for the possibility of visible scarring.
Skin Discoloration and Swelling
– Bruising and swelling normally occur after the brachioplasty procedure. The skin in or near the surgical site can appear either lighter or darker than surrounding skin. Although uncommon, swelling (including the forearms and hands) and skin discoloration may persist for long periods of time and in rare cases – may be permanent.
Changes in Skin Sensation or Numbness
– Itching, tenderness or exaggerated responses to hot or cold temperatures may occur after brachioplasty. Usually this will resolve itself during the recovery period, but in rare situations may become a chronic condition.
Sensation in Arm Tightness
– After the arm skin is lifted, there can be a sensation of the arm skin being tight. Usually this feeling will subside over time. Additional surgery may be required to correct this problem.
– Allergies to surgical tape, suture material and glues, blood products, topical preparations or injected agents can occur. Serious systemic reactions including shock (anaphylaxis) may occur to drugs used during the surgical procedure and or prescription medications. Severe allergic reactions may require additional treatment.
– Allergic reactions to suture material can be common. Sutures that spontaneously poke through the skin, become visible or produce irritation requires medical attention with the removal of the dissolvable stitches. This is also known as “spitting a stitch”.
Reaction to Anesthesia
– Fortunately most “bad reactions” to anesthesia are not life-threatening. However, all forms of anesthesia including the different forms of local, can carry a risk of an allergic reaction. Anesthesia exposes the body to controlled levels of toxic chemicals in order to make sure there is no pain felt during a surgical procedure. The main goal of anesthesia is to either stop pain temporarily or to induce a semi-conscious or unconscious state. Even though anesthesia carries a risk, the benefits outweigh any potential disadvantage.
– The most important factor is making sure that whoever administers the anesthesia are board certified in anesthesiology. By doing this, you reduce the risks of any complication that might arise during surgery. All body functions and chemistry are monitored during your surgery to ensure a safe procedure.
– The most common reaction or danger of having anesthesia is an allergic reaction to one of the medications used. This is addressed immediately by the attending anesthesiologist by monitoring your vital signs. If an allergic reaction occurs, your anesthesiologist is equipped to handle this immediately. Severe allergic reactions during anesthesia are fortunately rare.
It is very important to tell your anesthesiologist every medication you take on a regular basis, so that he can prevent any potential problem during surgery.