The surgery can be corrective to address excess skin which may be unsightly and can result in skin irritation, infections and issues with hygiene. The excess skin may result from weight loss following bariatric surgery, diet and exercise or following pregnancy.
The decision to undergo brachioplasty surgery is significant and adjustment to change in appearance needs be considered in addition to the process of post operative recovery.
The aim of such consultation is to ascertain patient expectations and to identify potential limitations to achieving those expectations such as the extent of skin excess, skin quality and adiposity. Brachioplasty surgery is best considered when a patient’s weight has been stable for at least 3 months. In appropriate patients, liposuction can be used as an adjunct to the brachioplasty procedure. The Surgeon will discuss this with you during the consultation.
It is important that the Surgeon is aware of previous surgery and history of scarring along with significant medical history including a tendency for easy bruising and excessive bleeding, deep venous clots involving the legs, all prescription and non prescription medication, allergies to anaesthetic agents, antibiotics and dressings, history of smoking and psychological or psychiatric issues. These issues are important as they have the potential to affect the surgery, anaesthesia, potential complications and recovery.
If necessary, further medical consultation may be necessary to minimize complications including consultation regarding blood thinning agents which may need to be ceased or commenced in preparation for surgery. If advised by the Surgeon, it may also be necessary to cease medication such as the Oral Contraceptive Pill. It is important to avoid Aspirin, Disprin and non-steroidal anti inflammatory medication such as Nurofen in addition to herbal medication such as Garlic, Ginseng, Ginko and Fish and Krill oil two weeks prior to and after surgery. It is essential that smoking ceases six weeks prior to and after surgery to minimize the risk of surgical wound complications and anaesthesia. Nicotine containing products can also affect wound healing and should be ceased two weeks prior to and after surgery.
Diagnostic tests including blood tests may also be necessary for the Surgeon to obtain a complete assessment of bleeding tendencies and to optimise fitness for general anaesthesia.
A further significant aim of consultation is to facilitate understanding of the potential risks of brachioplasty surgery.
Risks which are infrequent but common to all operations include problem scarring such as keloid or hypertrophic scar formation, wound complications including infection, wound breakdown, haematoma formation (bleeding) or seroma formation (tissue fluid collection) in addition to the risk of further surgery to address these potential complications.
Risks specific to brachioplasty surgery which improve over eighteen months to two years include swelling and redness of the skin and numbness of the inner arms and forearms. Those specific risks which may require revisional surgery include asymmetry and dog-ear formation, which are contour irregularities at either end of the scar. Revisional surgery is necessary in approximately 5 per cent of patients who undergo brachioplasty surgery.
It is only at the culmination of the consultation process, after having the opportunity to have questions addressed by the Surgeon, should consent to brachioplasty surgery be given. The consent process will also include discussion regarding the costs of surgery and potential revisional surgery.
In Australia, surgeons are strongly discouraged from advertising a set price for a medical procedure. This is in line with the Guidelines for advertising of regulated health services by the Australian Medical Board. For this reason we do not include a cost per procedure on our website.
Once Mr Patrick Tansley or Dr Sugitha Seneviratne have met with you in an initial consultation, part of this consultation will be to discuss the cost of this procedure. We can provide approximate costs for out of pocket costs before your initial consultation including any applicable Medicare rebate. We are happy to provide these by phone 03 9088 5000 or via enquiry through our website.
The cost of an initial consultation with a Surgeon to discuss your procedure is $175 ($225 for weekend consultations). A portion of this cost may be claimed from Medicare if you have a referral from your GP. During your consultation you will be given a personalised cost or quote for your surgery. You will need to allow one hour for your consultation.
The procedure is performed under general anaesthetic through incisions which are placed on the inner aspect of the arm extending from the armpit to the elbow. The Surgeon will discuss the extent and length of the scars prior to surgery and a wedge of skin and fat tissue removed to optimize the contour of the upper arm.
The internal wounds are repaired with dissolving stitches and there may a small number of external skin stitches which are removed seven to ten days after surgery. Drainage tubes are used to drain tissue fluid and blood.
At the completion of surgery a waterproof dressing is applied which is suited to showering and a compression garment applied to minimize soft tissue swelling.
Following monitoring in the recovery room, patients are discharged to the care of a responsible adult for 24 hours. At the time of discharge, appropriate pain medication and antibiotics will be dispensed and it is important that these be taken to minimize discomfort and potential wound complications.
It is important that access to medical attention is available by telephone if necessary. Issues which the Surgeon needs to be made aware of urgently include temperatures exceeding 38 degrees Celsius, bleeding to the extent that the dressings soak through with blood, pain not controlled by the medication, redness of the arm or forearm skin or any concerns related to the surgery.
In order to minimize post operative bruising elevation of the arms should be maintained with pillows for 7 days. In general, swelling and bruising increase over the first three to five days and improve between five to ten days. In some instances, it may take several months for the soft tissue swelling to subside completely. During this period the sensation of the arm and forearm skin may be affected but will return to normal over a few months.
During post operative visits the dressings will be changed as appropriate and wound healing will generally take approximately 3 weeks to achieve. During this period arm movement should be minimized to optimize wound healing and driving a motor vehicle avoided for 2 weeks.
Resumptions of physical activity such as walking for exercise can commence three weeks after surgery, progressing to running at six weeks and normal exercise including swimming at eight weeks. It is important to avoid upper arm trauma from being knocked or hit accidentally for six weeks after surgery. Return to work can be anticipated after two to three weeks.
The final result of brachioplasty surgery may not appreciated for many months as the inner arm scar can be unpredictable and will be visible when the arm is raised for up to 18 months after surgery. Instructions on swelling and scar management strategies such as massage, taping and silicone gel sheeting will be provided during post operative consultations. The aim of scar maturation strategies and swelling management is to optimize the resolution of thickness of scaring and soft tissue swelling with the aim of achieving an optimal result as expeditiously as possible.
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