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Friday September 03 , 2010

Brachioplasty or Arm Lift in Orange County, Los Angeles, Riverside, California

Southern California plastic surgeon Dr. Agha invites you to learn more about arm lift plastic surgery in Newport Beach. Please choose from the following topics:

Arm Lift (Brachioplasty) in Orange County and Los angeles

General Information on Arm Lift

Consultation with Dr. Siamak Agha

Arm Lift Surgery

Limited Brachioplasty

Extended Brachioplasty

L-Brachioplasty

Typical Arm Lift Patients

Procedure Details

Recovery After Arm Lift

Arm Lift Results

Potential Risks of Arm Lift

Relative Contraindications to Arm Lift Surgery

  • Severe comorbid conditions (heart disease, diabetes, morbid obesity, cigarette smoking, etc.)
  • Expecting future pregnancy
  • Thromboembolic disease (blood clotting disorders)
  • Morbid obesity (BMI >40)
  • Unrealistic patient expectations
  • Patients who tend to form keloids or hypertrophic scars

Surgical Risks and Potential Complications of Arm Lift Surgery

All surgical procedures, including the arm lift, have potential risks associated with their performance. The decision to have brachioplasty or other body contouring surgeries is extremely personal, and you’ll have to decide if the procedure will achieve your goals and whether or not the risks and potential complications are acceptable.

In this section, you will find further information regarding the potential risks associated with various brachioplasty procedures.

Possible Risks of Brachioplasty Include:

Surgical anesthesia: On the day of surgery, your anesthesiologist will discuss with you the risks of both local and general anesthesia.

Unfavorable scarring: If the sutured area doesn’t heal properly or the area takes too long to heal, the brachioplasty scars may be thicker than normal. If the patient heals relatively quickly, minimal scarring will result. Scars will take years to fade, but they are permanent. Despite Dr. Agha’s best efforts, scar appearance and healing are not fully predictable. The scars may be uneven, excessively wide, and/or asymmetrical. Scars may be unattractive and of a different color than the surrounding skin. Excessive, hypertrophic, and keloid scarring are uncommon. Additional treatments, including surgery, may be necessary to treat abnormal scarring.

Bleeding/Hematoma: Bleeding may result if the sutured areas do not heal correctly or if there is improper coagulation after the arm lift procedure. A hematoma is a blood collection that can form under the skin and enlarges as a tender bulge.If a patient notices any unusual bleeding after brachioplasty, they must contact Dr. Agha immediately. Do not take any aspirin or anti-inflammatory medications for ten days before surgery as this will increase the risk of bleeding. Non-prescription “herbs” and dietary supplements can also increase the risk of surgical bleeding.

Infection: Major Infection with fever and large areas of red skin (cellulitis) is unusual after this type of surgery. Should a serious infection occur, treatment including intravenous antibiotics or additional surgery to remove dead tissue and drain abscesses may be necessary. Minor wound infections accompanied by exposed and “spitting” sutures can occur and are usually easily dealt with by limited debridement, antibiotics, and dressing care. There is a greater risk of infection in smokers, those with diabetes, and with multiple procedures.

Fluid Accumulation (Seroma): Drains are often placed at the surgical site at the end of the operation to collect the seepage of fluid. After their removal in about 5 to 7 days, body fluids (serum) occasionally accumulate underneath the skin. Should this occur, it may require aspirations. If that fails to cure the seroma, then the patient will need to be seen either in the office or operating room for the insertion of new drainage tubes and the removal of seroma cavities. This is very rarely necessarily.

Poor Wound Healing: Individuals that have a slower than average healing rate or those who are smokers may find that they do not heal properly, that the sutured areas reopen easily, or that they are more prone to infection. Patients should avoid smoking three weeks prior to and after the procedure so that their body’s natural healing process is not hindered.

Wound Dehiscence: In general, your skin closure is in multiple layers. Separation of the superficial, deep, and/or both layers may occur any time during your first post-operative month. Suture breakage, knots untying, sutures tearing through an excessively tight closure, too much movement or bending by the patient, and skin necrosis (death) are some of the recognized causes of dehiscence. Breakage of sutures in the superficial layer of skin may be sutured closed or allowed to heal secondarily at the judgment of Dr. Agha.
Deep dehiscence may require a return trip to the operating room for closure under anesthesia. These healing problems may require frequent dressing changes, extra office visits, and further surgery to remove the non-healed tissue. Open wounds may take weeks to heal or secondary closure may be appropriate. Wounds allowed to heal on their own usually benefit from secondary scar revision. Smokers have a high risk of skin loss and wound healing complications. Do not smoke for 3 weeks before and after your surgery.

Suture Granuloma: Some surgical techniques use deep sutures. These items may be noticed by the patient following surgery. Sutures may spontaneously poke through the skin, be visible, or produce irritation that requires removal.

Numbness in Skin Sensation: Post-operative diminished (or loss of) skin sensation (numbness, pins and needles sensation, burning or itching), and/or pain at the surgery site may be temporary or very rarely permanent.

Contour Irregularities: Contour irregularities and depressions may occur after these procedures. Visible and palpable looseness and wrinkling of skin can also occur. On occasion, asymmetrical fullness, bulges, and depression may be present.

Asymmetry in Scar Placement or Contour: On occasion, asymmetry may occur after an arm lift. Although this is not typical, it is a risk associated with the brachioplasty procedure. Every body and every patient is different.

Pain that may Persist: Chronic pain may occur very infrequently from nerves becoming trapped in scar tissue after surgery.

Nerve damage: If improper healing occurs, the patient may have some nerve damage. The possibility of nerve damage should be discussed with the physician before the procedure. Nerve damage can result in over-sensitivity, or it can result in a lack of sensitivity in certain areas where the arm lift was performed.

Allergic Reactions: In rare cases, local allergies to tape, suture material, or topical preparations have been reported. Systemic reactions which are more serious may occur to drugs used during surgery and prescription medicines. Allergic reactions may require additional treatment.

Residual Deformity: Despite best efforts to obtain a pleasing arm contour, a small degree of residual deformity may persist or develop months after the surgery.

Need for Revisional Surgery: The practice of medicine and surgery is not an exact science. Should complications occur or some aesthetic expectations remain unmet, additional procedures or other treatments may be necessary. Other complications and risks can occur but are even more uncommon.

Suboptimal Aesthetic Result: You may be disappointed with the results of surgery. Under treatment with residual laxity and looseness or over treatment with excessive tightness of skin can occur with flattening of regional contours and widening or thickening of scars. Considerable care is exercised to achieve the optimum shape, but for a variety of reasons, the ultimate results may be suboptimal. At times, it is desirable to perform additional procedures to improve your results.

Deep Vein Thrombosis (DVT) and Pulmonary Complications: Deep vein thrombosis is a rare but worrisome complication of plastic surgery. It represents formation of blood clots in the deep veins of the legs during anesthesia and surgery. Although a sequential compression device will be used to reduce the risks, few patients may still develop DVTs. Pulmonary complications may occur secondarily to migration of the vein blood clots into the lungs (pulmonary emboli) or partial collapse of the lungs after general anesthesia. Should either of these complications occur, you may require hospitalization and additional treatment. Pulmonary emboli can be life-threatening or fatal in some circumstances.

Long Term Effects: Subsequent alterations in body contour may occur as the result of aging, weight loss or gain, pregnancy, or other circumstances unrelated to the above procedures.

 

Arm Lift (Brachioplasty) in Orange County and Los Angeles

General Information on Arm Lift

Consultation with Dr. Siamak Agha

Arm Lift Surgery

Limited Brachioplasty

Extended Brachioplasty

L-Brachioplasty

Typical Arm Lift Patients

Procedure Details

Recovery After Arm Lift

Arm Lift Results

Potential Risks of Arm Lift

Results of Arm Lift Surgery in Newport Beach

Whether undergoing limited arm lift or extended arm lift, you will notice a flatter and firmer arm contour that is proportionate with your body type and weight. The final arm lift results may be initially obscured by swelling and bruising. Within a few weeks, most of the swelling and bruising will resolve, leaving behind slimmer, more beautiful arms.

Following arm lift surgery, many patients experience an immediate improvement in their self-esteem and discover a greater self-confidence. In addition, many also find greater access to different clothing styles and fashions and are less self-conscious at the gym, around the pool, or at the beach.

For most patients, the long-term results associated with the arm lift procedure are excellent. However, results are dependent on keeping one’s weight relatively constant, eating a healthy diet, and exercising.

 

Arm Lift (Brachioplasty) in Orange County and los angeles

General Information on Arm Lift

Consultation with Dr. Siamak Agha

Arm Lift Surgery

Limited Brachioplasty

Extended Brachioplasty

L-Brachioplasty

Typical Arm Lift Patients

Procedure Details

Recovery After Arm Lift

Arm Lift Results

Potential Risks of Arm Lift

Recovery from Arm Lift Surgery in Newport Beach

Arm lift surgery may be performed as an outpatient procedure, or you may choose to stay in the hospital overnight when additional procedures are performed. If you choose to go home, you will spend approximately one hour in the recovery room prior to being released in the company of a friend or family member.

  • Day of Arm Lift Surgery- When you wake up from your procedure, you will be in the recovery room and will have dressings and ACE wraps on your arms. You should have your arms wrapped from the wrist to the arm pit for the first 72 hours.
  • Caregiver- When patients leave the surgery facility to go home, they are usually groggy for about 12 hours or overnight. Thus, it is very important to have someone who can assist you with getting around and taking your medications for at least the first 24 hours.
  • Nausea- Most people are nauseated during the first 24-48 hours after surgery. To reduce this, we suggest that you take your nausea pill one hour before taking your pain pills or antibiotics.
  • Sleep- During the two weeks after your arm lift, attempt to sleep with your arms elevated on two to three pillows. This ensures drainage of fluids from your upper extremities, reducing inflammation and tension on your incision lines, reducing pain and resulting in a thinner scar during the initial healing process.
  • Painkillers- You’re likely to feel sore for a few days, but you should be up and around in 24 hours. Most of your discomfort can be controlled by the prescribed painkillers.
  • Shower- Remove your dressing and ACE wrap on the third day after your arm lift surgery. You may now take a shower. After showering, simply pat your incisions dry and begin wearing your arm compression garment.
  • First Post-operative Visit- Dr. Agha prefers to see you 3 to5 days after an arm lift procedure. 
  • Swelling- Any swelling in your arms may take three to five weeks to subside. Compliance with arm elevation will reduce this period.
  • Driving- It is not safe to drive a car within 24 hours of taking pain medication as your reflexes and alertness may be altered.
  • It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing.
  • Walking- Although your arms will be sore for several days, you should be up and walking the day following surgery. This is the best way to reduce the chances of blood clotting in the legs. You should be able to resume your normal daily activities within several days following surgery, and you should be able to resume all of your physical activities within three weeks of surgery.
  • Light Exercise- Dr. Agha recommends light exercise to reduce swelling and prevent clotting. Light exercise includes walking, stretching, and moving arms and legs while sitting. If you should feel pain or pulling of the scar area, cease the movement.
  • Activities- During the first week after arm lift surgery, you want to avoid activities that raise your blood pressure. This could cause bleeding at the operative site, which could result in a hematoma (collection of blood).
  • Walking is the safest exercise, especially during the first week. Avoid exercises which directly stress the area of your surgery for a full four weeks. After this period, cardiovascular activities such as riding a stationary bicycle or brisk walking can be initiated.
  • Avoid heavy lifting, contact sports, and jogging for up to six weeks. By the time you are at six weeks after your arm lift, you will be nearing your pre-operative state. Avoid pulling at the surgical area to maximize healing and minimize scarring. During the early phase of healing, one must avoid irritation around the operative site as this can worsen swelling and fluid accumulation. This could cause development of a seroma (fluid collection) or cause problems with the wound (dehiscence or opening of the suture line or widening of the scar). Even though the skin is closed, there are many activities taking place beneath the skin.
  • Healing- You will need a few weeks to recover and heal from an arm lift procedure. The typical healing time is at least one to two weeks before returning to work.
  • Scarring- Every person’s body is different, and many factors contribute to scar healing. Your scars will be firm and pink for about six weeks. Non-smokers and those who follow the Enhanced Recovery Nutritional Supplements routine have a better chance of having rapid healing and thinner scarring. Expect to wait at least 9 to 12 months before your arm lift scars lighten in color and become as flat as the rest of your skin.
  • Follow-ups- Regular checkups protect against complications.
  • Emergencies- Some discomfort is expected following your arm lift surgery. However, be sure to tell us if:
    • There is an increase in swelling, pain, redness, drainage, or bleeding in the surgical area.
    • You develop fever, dizziness, nausea or vomiting, or a general ill feeling.
    • If you experience shortness of breath, chest pains, or unusual heartbeats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
   

Arm Lift (Brachioplasty) in Orange County and Los Angeles

General Information on Arm Lift

Consultation with Dr. Siamak Agha

Arm Lift Surgery

Limited Brachioplasty

Extended Brachioplasty

L-Brachioplasty

Typical Arm Lift Patients

Procedure Details

Recovery After Arm Lift

Arm Lift Results

Potential Risks of Arm Lift

Details of Arm Lift Surgery in Newport Beach

Arm lift surgery usually takes two to three hours, depending on which type of brachioplasty procedure is performed and how much correction of the arm contour is desired and practical. After you have changed into a gown and had your intravenous line started, Dr. Agha will mark certain landmarks on your elbow, arm, and armpit in the pre-operative area. The location, length, and direction of these incision lines will be dictated by the type of brachioplasty being performed. This ensures proper planning for the site of the brachioplasty incision. He will also review the entire operative plan with you, including potential complications. You will then be given a dose of intravenous antibiotics as a precautionary measure.

arm-031

What happens during brachioplasty surgery?

Step 1 – Anesthesia
Brachioplasty can be performed either under local anesthesia with sedation “twilight sleep” or general anesthesia. After initiation of anesthesia in the operating room, Dr. Agha will inject a solution of local anesthetics known as “tumescent solution” at the intended incision site. The injection solution consists of a low concentration of lidocaine and epinephrine. The lidocaine will numb the surgical site, and the epinephrine causes constriction of the blood vessels at the surgical site, reducing potential for bleeding and bruising.

Step 2 – The incision
Dr. Agha will next make the necessary incisions for removal of excess skin and fat. The incision may be completely concealed within the armpit or down the inside of the arm in an inconspicuous location for a variable length, depending on how much skin and where the excess is. After the incision has been made, Dr. Agha removes the excess skin and fat and brings the incisions together. This provides a firmer and smoother arm contour.

Step 3 – Closing the incisions
The incisions are carefully closed to minimize your scarring. Dr. Agha places all his sutures beneath the skin where they are gradually absorbed by your body. Not having to undergo suture removal has improved patient comfort and satisfaction. Typically, Dr. Agha does not use drains for brachioplasty procedures.

Step 4 – Dressings
A sterile dressing is applied to the incisions, and a compression garment or ACE wrap is placed over your arms. This compression helps support your arms during healing, decreases post-operative swelling, and helps decrease any bruising that may occur.

 

Arm Lift (Brachioplasty) in Orange County and los angeles

General Information on Arm Lift

Consultation with Dr. Siamak Agha

Arm Lift Surgery

Limited Brachioplasty

Extended Brachioplasty

L-Brachioplasty

Typical Arm Lift Patients

Procedure Details

Recovery After Arm Lift

Arm Lift Results

Potential Risks of Arm Lift

Typical Arm Lift Patients in Newport Beach

Typical patients requesting an arm lift have significant laxity and excess tissue of the upper arm as can be seen from the picture below.

 

arm-lift-03-before 

Before

arm-lift-03-after

 After

   

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