Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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Brachioplasty is performed under general anesthesia to ensure the patient is completely unconscious and pain-free. The airway is protected, and vital signs are monitored continuously by a board-certified anesthesiologist or nurse anesthetist.
In some cases of mini brachioplasty or liposuction-only procedures, deep sedation combined with local anesthesia may be used. The choice depends on the extent of the surgery and the patient’s medical profile.
The surgeon marks the incision lines while the patient is awake and standing to account for gravity. Once anesthetized, the arm is prepped and draped in sterile fashion. The incision follows the pre-marked line, usually along the bicipital groove.
The surgeon carefully dissects the skin and subcutaneous fat away from the deep fascia of the muscle. This dissection is done with electrocautery to minimize bleeding. Care is taken to identify and preserve the medial antebrachial cutaneous nerve and the basilic vein to prevent sensory loss and bleeding.
Once the excess tissue is mobilized, the surgeon pulls it taut to determine precisely how much can be safely removed. This is a tailoring process. The goal is to maximize tightening without creating excessive tension on the closure.
The excess skin and fat are excised. In some techniques, the superficial fascial system is sutured to the deep fascia of the arm. This internal suspension relieves tension on the skin edge, helping prevent the scar from widening later.
The incision is closed in multiple layers. Deep absorbable sutures hold the tissue together, while fine sutures act to approximate the skin edges. Surgical glue or sterile tape is often applied over the incision to seal it.
Drains are frequently placed to remove fluid that accumulates between the skin and muscle. This prevents seromas, which can delay healing. The drains exit through small holes near the elbow or axilla.
The patient is moved to the recovery room, where they wake up. The arms are wrapped in Ace bandages or a compression garment. Hands are checked for color and warmth to ensure the bandages aren’t too tight.
Pain is generally manageable, but patients often feel a sensation of tightness. Elevating the arms on pillows helps reduce swelling. Once stable, the patient is discharged to their caregiver.
Pain following brachioplasty is typically moderate. It is often described as a burning sensation along the incision and a deep ache. Surgeons prescribe oral narcotics for the first few days, transitioning to non-narcotic pain relievers as soon as possible.
Anti-inflammatory drugs are usually avoided for the first week to prevent bleeding. Nerve pain can occur as nerves heal and is sometimes treated with medications like gabapentin if persistent.
Patients are responsible for managing their drains at home. This involves stripping the tubing to prevent clots and measuring the fluid output daily. Drains are typically removed in the surgeon’s office when the output drops below a specific threshold.
This usually occurs within 3 to 7 days but can take longer. Drain sites are covered with a small dressing once the tubes are removed and heal quickly.
Arm movement is strictly limited during the initial recovery. Patients are instructed not to raise their arms above shoulder level for at least 2 to 3 weeks. This prevents tension on the axillary portion of the incision.
Lifting is restricted to light objects. Driving is prohibited while on narcotics and restricted until the patient has a full range of motion to steer safely, usually 1 to 2 weeks. Walking is encouraged to prevent blood clots.
Swelling in the hands and forearms is common due to the disruption of lymphatic channels and the tightness of the compression garment. Keeping the hands elevated above the heart helps mitigate this.
Bruising may track down the forearm due to gravity. The majority of swelling subsides within 3 to 4 weeks, but residual swelling can persist for months. The compression garment must be worn 24 hours a day for the first 4 to 6 weeks.
Patients can typically shower 48 hours after surgery, even with drains in place. The incisions should be gently washed with soap and water, then patted dry. Soaking in baths is prohibited.
Incision lines may be covered with surgical tape, which falls off on its own. Patients monitor for signs of infection, such as increased redness, heat, or a foul odor.
Most surgeons use absorbable sutures that do not need to be removed. However, if non-absorbable sutures are used, they are typically removed at 10 to 14 days.
Sometimes, a spitting suture may appear weeks later as a small pimple. This is a minor issue that the surgeon can resolve efficiently in the office.
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A standard brachioplasty typically takes between 2 and 3 hours to perform. If it is combined with other procedures, such as a breast lift or liposuction of different areas, the time will increase accordingly.
Yes, drains are very common in arm lifts to prevent fluid from building up in the space where the fat used to be. They are annoying but crucial for a safe recovery and are usually removed within the first week.
You should not lift your elbows above your shoulders for at least 2 weeks. Reaching high puts stress on the armpit incision, which is the area most prone to opening.
The surgery and the compression sleeves on your upper arms can temporarily slow the drainage of fluid from your hands. This is normal. Keeping your hands elevated on pillows when sitting or sleeping will help gravity drain the fluid.
Most patients describe the recovery as sore and tight rather than excruciating. The skin feels very tight initially. Pain medication controls the discomfort well, and most people switch to Tylenol within a few days.
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