Recovering From Brachioplasty (Arm Lift) Surgery

An Arm Lift (Brachioplasty or Arm Reduction) is a surgical procedure that removes loose, excess skin from the upper arm. Typically, patients have lost a large amount of weight and are concerned by the abundant excess skin and fatty tissue that remains. While exercise can strengthen and improve the underlying muscle tone, it can never eliminate excess, loose skin in the way surgery can.

If you’re interested in Arm Lift surgery, this article details what to expect on the day of the surgery and during the recovery period in the weeks after.

Types of Arm Lifts

Your recovery will partly depend on the type of Arm Lift surgery you have. Dr Dona performs three different types of Arm Lifts. After your Initial Consultation, he will advise you on the appropriate Arm Lift option for you. The types of Arm Lifts are as follows:

• Arm Lift Using Liposuction: For some individuals with mild-to-moderate excess arm tissue, Liposuction may be all that is required to improve form. A benefit of this procedure is that there are no scars. However, Liposuction only removes fat and cannot remove excess skin. This is ideally suited to individuals who have good quality arm skin that is firm but has an excess amount of fatty tissue, especially along the back of the arm.
• Arm Lift with Minimal Incision: This procedure involves making surgical incisions where the inner upper arm joins the armpit. This procedure suits individuals with only a small amount of excess skin near the armpit.
• Traditional Arm Lift (Full Brachioplasty): A traditional Arm Lift involves an incision made on the inside of the upper arm. It suits individuals who have lost a significant amount of weight. The excess skin and fat tissue are removed, and then the skin is tailored and enclosed using several layers of internal stitches.
• Extended Arm Lift: This is typically required for those who have lost a massive amount of weight and have excess skin concerns extending beyond their arms and onto the upper outer chest wall (below the armpit). In this procedure, the scar extends from the elbow to the armpit and down the outer chest toward the outer breast region. It is often combined with a breast reduction or lift.

YOUR RECOVERY

What To Expect On The Day Of Surgery

Your Arm Lift surgery will be performed in a private hospital under general anaesthetic. Some individuals can have the procedure in a day surgery and go home that night. Others will spend at least one night in hospital, with some patients feeling more comfortable staying an extra couple of nights.

Depending on your procedure and the reconstructive work required, surgery can take anywhere between two and four hours.

Immediately After Your Procedure

You’ll wake to find one plastic tube or drain placed next to your wounds on either arm. You’ll have at least one drip giving you intravenous fluids, pain control medications and antibiotics. Your hands will be swollen and will typically worsen over the next few days. Be patient and allow a few weeks before they return to normal.

You will also wake up from surgery with compressive arm sleeves on.

You may experience some pain or discomfort; however, you’ll be given pain medication to alleviate this. (You’ll also be given pain medication to take home.)

Depending on how long you’re booked to stay in the hospital, you may also wake from surgery with a catheter in place. This makes it easier to rest without getting up and going to the toilet.

To help prevent DVT, the hospital team will carry out various procedures. You’ll have special massage devices on both legs to help promote blood flow and minimise the chance of developing leg clots. You’ll be encouraged to do simple exercises such as tapping your feet or wriggling your toes. These exercises will activate your calf muscles and promote blood flow. You’ll also be given a blood thinner injection once a day while in hospital.

Your wounds are stitched using several layers of internal dissolving sutures, and the wound will be covered using a waterproof dressing. You might have some visible sutures—these will be removed at your one-week post-operative appointment.

The Day After Your Procedure

Your hospital nurse or physiotherapist will help you out of bed the day after surgery. Your drips, drains and catheter will be removed. (However, if you go home the same day as your procedure, your drains will stay in place and be removed the following day at your first post-operative appointment.)

After everything has been removed, you can have a shower with assistance. You’ll be given pain medications and antibiotics to take home with you; you must take them strictly as prescribed.

Your First Week Home

Help at home: We recommend having someone with you for the first week following your surgery to help with daily care.

Bloating and constipation: These issues are common after surgery as you are less mobile and have taken strong pain medications, which slow the bowels. To alleviate this, drink plenty of fluids, eat a high-fibre diet and take gentle laxatives, such as Movicol.

Gentle movement: Getting up and gently moving around the house is recommended. This encourages blood flow and helps prevent swelling and any post-surgical complications.

Minimise arm movements: Your arms and upper body will feel quite stiff, especially with the Extended Arm Lift. Keep your arms and elbows tucked by your sides as much as possible to minimise unnecessary tension on your wounds.

Keep your wounds dry: Do not have baths or swim until three weeks after surgery.

Sleeping: Feel free to sleep in any position you are comfortable in.

Swelling: Your hands will initially be very swollen. A significant amount of this swelling should have subsided in one to two weeks. Don’t be surprised if swelling is different in each arm.

Dressings: Leave your dressings on until your first post-operative appointment. During this appointment, your practice nurse will inspect your wounds, commence post-operative treatments (such as LED light therapy, which helps reduce inflammation and promote healing) and change your dressings.

Compression garment: When you wake from surgery, you’ll have a compression garment on your arm. This snug, elasticated garment significantly helps your recovery by controlling swelling and reducing tension on the wounds.  You must wear your compression garment four to six weeks post-surgery. The constant pressure from your compression garment helps ensure that your arm is healed to the optimal shape while also minimising the appearance of your surgical scars.

Walking: During your first week, you should regularly get up and take short walks around the house. Be guided by your body, and remember that several short walks are better than just a few long walks.

Sexual activity: You can resume sexual activity any time after your surgery, provided you understand the following:

• Your wounds and the surrounding areas should not be firmly handled for the first six weeks.
• Any engagement in sexual activity should take on a passive role.
• Avoid activities that increase your heart rate and blood pressure during the first two weeks, as this can increase the risk of swelling and bleeding problems.
• Do not engage in physical activities where you must exert, strain or stretch your upper body muscles for the first six weeks.

Two To Three Weeks After Your Surgery

Exercise: After two weeks, you can do basic cardio training, such as riding an exercise bike or walking on a treadmill. Avoid any weights workouts, including lower body work.

Driving: After two weeks, you can consider driving, provided you feel safe doing so.

Returning to work: If your work involves light office or desk work, you can consider returning to work at around the two-week mark. (Light hospitality work can be resumed after four weeks, and any work involving heavy lifting or straining can be considered after six weeks.)

Bathing: After three weeks, your wounds are now allowed to be wet, and you can take a bath or swim if desired.

Four Weeks After Your Surgery

You should consider your first four to six weeks as your ‘recovery phase’. After this time, you enter your ‘rehabilitation phase’. During this phase, you can slowly take on any physical activities you were doing previously, provided you practice commonsense caution and be guided by your comfort and strength.

Six Weeks After Your Surgery

You should feel well on your way to recovery at the six-week mark. However, it will take approximately six months to feel completely back to ‘normal’.

Compression garment: You will no longer need to wear your compression garment.

Work: Work, in any capacity, should be able to be resumed.

Exercise: You can resume all regular exercise, including cardio activity and weights.

Six Months After Your Surgery

At six months after surgery, you should be feeling back to ‘normal’ and be able to do all the activities you did before surgery.

NB: You must regularly attend post-operative checkup appointments for the first six months after your surgery. These appointments will be shared between Dr Dona and the practice nurses.

About Scars From Arm Lift Surgery

Given that our arms are highly visible, one of the most common — and valid – concerns about arm surgery is scarring. Scarring is undoubtedly a consideration with Brachioplasty; however, you must remember that the trade-off is having thinner, tighter arms without any excess skin hanging.

If you only require Liposuction for your Arm Lift, you’ll only be left with some tiny incision marks made for the cannula. However, an Arm Lift With Minimal Incisions leaves surgical incisions where the inner upper arm joins the armpit.  A Traditional Arm Lift (Full Brachioplasty) typically requires a surgical incision along the inner upper arm, from the elbow to the armpit.

When it comes to the degree of scarring, younger people tend to form better scars than older people — particularly if they have underlying conditions such as diabetes.

Everyone has different healing abilities, and this also affects how scars heal. Unfortunately,  Brachioplasty scars tend to become hypertrophic or keloid far more often than scars forming in other body parts.

Hypertrophic scars – are raised, thick, discoloured scars that stay within the boundaries of the initial wound.

Keloid scars – extend beyond the boundaries of the initial wound and are darker than the patient’s skin colour.

African, Asian and individuals with Hispanic backgrounds tend to form keloid scarring more often. If you’ve had a keloid or hypertrophic scar before, or a family member has had such a scar, then you are at a higher risk of developing one after Brachioplasty.

How to Minimise Brachioplasty Scarring

Your Brachioplasty scars will begin to fade at six months; however, they will take up to two years to fully mature. And, as they mature, they will start to fade.

While scars from Brachioplasty will be noticeable, there are steps you can take to minimise their appearance significantly.

Choose an experienced surgeon: Dr Dona is a specialist plastic surgeon with considerable experience in Brachioplasty, and choosing such a surgeon can contribute significantly to a successful outcome. For example, his experience allows him to determine the best placements and lengths of your incisions and use optimal techniques to help keep scars as small as possible. He’ll also give a detailed post-operative plan involving multiple weekly in-clinic post-operative care visits with our nursing team. Not only will this allow him to provide optimal care, monitoring your wounds at every milestone, but the nursing team can regularly administer treatments to accelerate healing and minimise the appearance of scars.

Wear your compression garment: This will help with healing and prevent the wound from stretching and forming a wider scar.

Avoid sun exposure: The sun’s UV rays will darken scars and hinder the vital collagen formation required for scar healing.

Avoid touching any scabbing: Picking at any scabbing along the incision line can worsen the scars, so make sure you leave them alone.

Avoid smoking: Smoking constricts blood vessels, making it more difficult for oxygen to reach the tissues. Consequently, it hampers the healing process. Your wounds won’t heal as quickly, and it will take longer to see the results. Smoking also increases the chances of inflammation and infection and compromises your immune system. Further, when the tissues are starved of oxygen, it can cause tissue necrosis (tissue death). Therefore, you mustn’t smoke or ingest any nicotine-based products. If you can’t quit, you must abstain for several weeks before the procedure and several weeks afterwards.

Vitamin E: After approximately four weeks, gently rub vitamin E oil into the scars. Do this once a day for the next couple of months.

Silicone sheets, gels and taping: Silicone can help improve hydration, reduce itching and discomfort, help the skin’s natural repair mechanism and improve scar healing—silicone sheets, gels and taping all work to provide these benefits. In particular, silicone tapes exert gentle pressure on the scar, which helps prevent raised and hypertrophic scars.

In addition to the above tips, you can optimise your healing by having specific in-clinic procedures. At Bella Plastic Surgery, every patient receives various post-treatment in-clinic procedures, which are included in the fee. These include LED Light Therapy, Microneedling, PRP (Platelet Rich Plasma) and other injectable treatments (e.g. Rejuran). Patients are also given medical-grade skincare to use at home. Typically, these treatments start the day after your hospital discharge.

LED Light Therapy: This therapy minimises information and can reduce scar redness, helping scars fade more quickly. The LED light stimulates your body’s healing cells to mature your scars more rapidly, providing optimal scar formation. Patients are given LED light therapy each post-procedure visit for up to three to six weeks.

Micro-needling: This treatment (aka Skin Needling) encourages healing and scar quality. Tiny needles create micro-injuries to the scar, triggering your body’s natural healing response. It also improves the texture of your scar while reducing discolouration. Micro-needling is an optional treatment that is recommended to start three weeks post-surgery. Three to four treatments are recommended, four weeks apart.

PRP (Platelet Rich Plasma): Using your own platelets, this treatment helps kickstart the healing process. Platelets have proteins and growth factors which encourage regeneration, repair and healing. The treatment involves taking blood from your body and then treating it to isolate the platelets. The platelets are then injected directly into the scar for the regeneration to begin.

Rejuran: This highly rejuvenating treatment contains polynucleotides – DNA fragments from salmon. The treatment is injected directly into the scar to promote skin rejuvenation and elasticity while reducing inflammation. Rejuran is an excellent treatment for those who are not suited to PRP treatment. Rejuran and PRP treatment typically begins at the first post-surgical consultation. Some patients require just one treatment, while others benefit from two treatments, four weeks apart.