An important factor in brachioplasty, as with all major tightening operations on the torso, is that there may be residual scars if the suturing technique and wound healing are poor. This must be made clear to the patient before the operation.
An important preoperative stage in the operation is to mark the surplus skin to be resected precisely on the patient, who should be standing. The size of the resection is also a decisive factor in the successful outcome. If too little is resected, this will result in folds in the medial area of the upper arm. If too much is resected, hypertrophic scars may form.
The surgical technique is simple. It basically consists of dissection of a cutaneous/fatty flap from the fascia of the upper arm, step-by-step resection and wound closure in three layers. As the patient is often worried about a large caudal scar extending to the epicondyle of the upper arm, we have developed a modified technique: the "fish mouth" technique. With this technique, the tightening is not performed vertically and primarily on the upper arm, but horizontally and on the skin of the axilla. With this type of incision, the incision on the inside of the upper arm does not extend beyond the cranial third. Postoperative scar care is also important with this type of incision. The patient must be monitored for 24 h after the operation, and the special compression dressing can be removed after 8 days.
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