Surgical method of an arm lift or brachioplasty
How can I know if surgery is right for me?
Can I get the same results without surgery?
How much will the operation cost?
Will my insurance pay for this surgery?
Am I being vain to have this operation?
What do I do to get ready for surgery?
Do I take my regular medicines before surgery?
Are there any medicines I should not take before surgery?
What do I eat before surgery?
Is there anything I can do to reduce scarring or bruising?
Is there anything I need to tell my surgeon before surgery?
12. Do I need any special tests or X-rays?
If you are in good health and we plan a local anesthetic, you may not need any special tests or X-rays. If you suffer from a serious illness, such as diabetes, I may order tests or suggest you see your treating physician. If you are going to have a general anesthetic, the anesthesiologist may order special tests to prepare for the anesthetic. Most plastic surgeons take photographs before and after surgery.
13. How early do I need to be at the operating suite before surgery?
I recommend that you are at the operating suite one and a half hours before surgery. Although this seems early, it is necessary to get the best result for you. Often I prescribe medicines before surgery that make you feel comfortable during surgery. If you do not have these medicines on time, they are not as effective. If you need special tests, it often takes an hour for results to return. If you do not arrive at the recommended time, for your own safety, I may cancel or postpone your surgery.
14. Where is the operation done?
I will do your operation in an operating room, often at a day surgery unit. Usually I do surgery in the early morning. Unless you decide to stay in the hospital or unit overnight you can be home within a few hours.
15. How is the operation done?
The principle of the operation is straight forward. The skin of the arm is stretched and the excess is removed. Sometimes I may use liposuction to smooth the edges and reduce the volume of the arm.
16. Where is the scar going to be?
The scar for a arm lift is usually placed along the inner side of the upper arm. It may go around the arm and is long. If only the inner or outer arm is to be tightened the scar may be shorter. Sometimes I use a second incision that goes at an angle from the main scar. All surgery requires a scar and all scars take time to soften and fade. You will not see the final appearance of your scar for a year after surgery. It is usually red and raised for the first month or two after your operation.
17. How long does the operation take?
Your operation usually takes about two hours. You should allow two hours to recover in the surgery unit.
18. When will I be able to go home after surgery?
After I finish your operation you will go to the recovery room for about two hours. When the nurses feel you are alert you can go home or be admitted.
19. Can I drive myself home after surgery?
No. this is major surgery. After surgery you will be under the influence of medications. It is dangerous to drive even the day after surgery. If you do not have anyone to drive you home we can call a taxi. Tell the nurses in the surgery unit.
20. What anesthetic is used for the operation?
This operation is performed under a general anesthetic, this means you are asleep. Although small, there is a risk to all anesthetics.
21. What are the complications?
After all operations there is bruising and swelling. This lasts about two weeks but can continue for a month or more. Remember that the human body is asymmetrical and that even after surgery both sides of the body will look different. All surgery requires an incision and therefore will leave a scar. In most patients the scar heals well, but in a small number of people the scar remains thick and heavy At the time of surgery the small nerves that supply feeling to the skin are damaged. This may cause changes in sensation including numbness. Although uncommon, bleeding and infection are risks and can be serious. You will have pain and discomfort after this surgery. The pain usually only lasts for a few days. One per cent of all operations lead to major complications. Weigh up the pros and cons, it is for you to decide. This is a surgical procedure and as such potentially serious complications such as a blood clot or embolus or an unexpected response to drugs or anesthetics can occur. Beside the complications that can develop after any surgery, there are problems that are special for your surgery. These include: the scar is long and may be slow to heal, it is not unusual to have scabbing along the scar for several weeks, and fluid(either blood or serum) can collect under the skin flap. Make certain you understand all consent forms: check out this page from the American College of Surgeons about surgical permits.
22. Will I need to take any special medicines?
I usually prescribe a pain killer and a mild sleeping tablet for you to use after surgery. In most cases I will also prescribe an antibiotic and something in case you feel nauseated. If I prescribe an antibiotic it is important that you take it as prescribed on the bottle. The other medicine you can take at your discretion. If you think you may be allergic to any of the medicines I prescribe please call my office immediately. Remember that all medicines have side effects. One of the most common is gastrointestinal upset. This means you can have an upset stomach or diarrhea. If this becomes severe call my office. As soon as possible stop taking narcotics and sleeping tablets. Many patients are surprised that they can obtain good pain relief with simple over-the-counter medicines like Tylenol and Advil. Do not take aspirin because this can increase the risks of bleeding. Narcotics and sleeping tablets will interact with alcohol so do not drink at the same time as you take them. They will also make you drowsy so do not drive while you are taking them.
23. How do I look after myself after surgery?
You can follow some simple rules to make your surgical experience more pleasant. First acknowledge that you have had surgery and it takes time to heal. Be patient. For the first twenty-four hours take it easy and rest a lot. this is a good time to read all those books or watch the videos that you have been promising yourself you would read over the last few months. After the first day or two you will start to feel more comfortable but you are still not ready to begin vigorous activity. Keep the area of surgery elevated and apply ice as directed. I will give you specific instructions if needed. Take plenty of fluids and eat a balanced nourishing diet. I suggest additional vitamin C for about six weeks. Do not take extra vitamin E at this point because it can increase bleeding. It is very important that if you have any questions you call the office. You should not drive yourself for a week after surgery.
24. Do I need somebody with me after surgery?
Most patients feel more comfortable if they have somebody with them for the first few days after surgery. If this is impossible for you then I suggest you consider staying in the hospital.
25. Does it hurt after surgery?
All surgery is associated with pain and discomfort. For this reason I will give you a prescription for pain killers. Remember you can often get good pain relief with simple over-the-counter medicines like Tylenol and Advil. Do not take aspirin because this can increase the risks of bleeding. By the end of the first week the pain is usually much less.
26. What will I look like after surgery?
All surgery is associated with bruising and swelling, so you should expect this for one to two weeks after your operation. Some patients remain bruised longer and in rare cases up to a month. You may start to see the results quickly but you will not see the final benefits of your surgery for many months. I do not consider you fully healed for a full year.
27. Will I like the results?
You satisfaction with the results is very important to me. Most patients are happy with the outcome and serious complications are unusual.
28. What happens I do if I do not like the results?
No surgeon can give a guarantee about the outcome but I can say that I will work with you to achieve the result you want. If this means additional surgery I will usually do this for you without a surgical fee, if I think it is medically safe.
29. When can I return to work?
After any operation it is necessary to rest completely for a day or two. During the first week you will begin to feel more like yourself. By the end of a week you may be able to perform light duties such as using a telephone or computer. You should not do any heavy lifting for at least a month. This is major surgery and you will feel tired for several weeks.
30. When can I exercise?
I encourage you to begin gentle short walks at the end of the first week after surgery. A serious complication of any surgery is the development of blood clots in the legs as a result of inactivity. The risk of this is reduced by early movement. Begin to walk around as soon as possible after your operation. After two weeks you can begin more vigorous activity but you should not do any heavy lifting or vigorous jogging for at least four weeks. Sometimes there are exceptions to these rules. If you have any special needs, please ask me.
31. Do I have to eat a special diet?
I recommend that you eat a balanced diet and drink plenty of fluids. I like my patients to have additional vitamin C for about six weeks after surgery. Do not take extra vitamin E at this point because it can increase bleeding. After two weeks additional vitamin E by mouth may reduce the risks of thickening of the scar.
32. Afterwards do I need to wear any special clothing or garment?
At surgery I will apply tape or a compression garment this needs to be worn for several weeks until the swelling and bruising has gone.
33. Will I need to change any bandages?
If you need to change your bandage either I or one of the nurses will give you instructions.
34. Will I have drains?
Drains are soemtimes used after this operation. I use drains for two reasons. One is to remove fluid such as serum or blood that would otherwise collect under the skin. The other reason is to pull the skin against the underlying tissue to allow it to stick in place. If you have drains when you leave the surgery unit you will be given instructions on their care before you go home.
35. How do I look after my stitches?
You do not need to do anything special with your stitches. If I need you to clean the area I will tell you. You may have paper tapes or steristrips over the stitches do not remove these tapes. They are an important part of the repair. You may get them wet but do not rub soap into them. I almost always use stitches that dissolve. This mean your stitches do not have to be removed.
36. How long does it take to heal?
Healing is a slow process and varies dramatically from person to person but this graph may help you understand the process. It takes almost six weeks for any scar to begin to soften and a full year to be complete.
37. Will I need a catheter?
Usually not, but I may recommend a catheter after surgery if it is difficult for you to go to the bathroom. This is removed before you leave.
38. When can I bathe or shower?
You can bathe twenty-four hours after your drains are removed. If stitches are exposed or you have paper tapes it is fine to get them wet, but do not massage the area of the incision or rub soap into the tapes.
39. Do I have to sleep in any special position?
You may sleep in any comfortable position but try to avoid putting tension on the incision line. A recliner is a good way to position yourself. Try to avoid pressure on the area of surgery and follow any special instructions you may have been given after surgery.
40. Do I need to use ice on the surgical site?
If you apply ice carefully for the first twenty-four to forty-eight hours you may have less pain and swelling. I recommend that you apply the ice for about fifteen minutes every hour while you are awake. There should always be something between the ice and the skin so that you do not damage the skin. After the first two days ice will probably make no difference but if you find it makes you feel more comfortable then continue for a few more days.
41. When can I have sex?
You can resume sexual activity as soon as you feel comfortable. For two weeks avoid pressure at the site of surgery and do not massage the area.
42. Should I stop smoking around the time of surgery?
Yes. Smoking delays healing and can cause your skin to die leaving bad scars. I like my patients to stop smoking for two weeks before and after their operation. If you need help to stop, contact the American Lung Association 212/315 8700 or get information to help you stop smoking from the University ofArizona.
43. May I drink alcohol around the time of surgery?
Narcotics and sleeping tablets will interact with alcohol so do not drink at the same time as you take them. They will also make you drowsy so do not drive while you are taking them. After the first few days when you are not taking pain killers you can drink a small amount of alcohol.
44. Can I combine the operation with other procedures?
A major trend in the last few years is for patients to have more than one operation at the same time. This reduces cost and means you only have one period of recovery and pain. In my experience this does not significantly increase the risks of surgery.
45. How will I feel emotionally after surgery?
Some patients feel emotional after surgery. Some even become depressed. If this happens to you do not feel you are alone or frightened. It will almost certainly pass. Talk to me about it. If it becomes persistent or serious I can help you find a counselor.
46. How long will the results of surgery last?
This depends a great deal on the individual patient and the type of skin but unless you gain weight the results are very long lasting.
47. Can I have the operation again?
Almost all surgery can be repeated. Still for most patients this is not needed. As time passes we may find that we need to modify or "update" something that we had done several years ago. This is usually not a problem. Secondary liposuction can sometimes help if you gain a small amount of weight.
48. Do I tell people I have had cosmetic surgery?
Cosmetic surgery is a very personal matter. Only you can decide who should and should not know you have had surgery. I recommend that you talk about surgery with at least one other person you know well. Your spouse or a good friend are obvious examples. You could also discuss surgery with a therapist or your family doctor. Unfortunately, even today many professional people are not well informed about cosmetic surgery. If you let those close to you know about the operation then you can ask for help afterwards without being embarrassed or shy.
49. When can I go to the gym after surgery?
Gentle exercise can begin after two or three weeks but vigorous exercise or strengthening of the arm muscles should not begin for six weeks. Even then you should begin gradually.
50. How do I reach my doctor if I have an emergency?
Serious emergencies are rare after this surgery. The quickest way to reach your doctor often through the office number. The office staff will call the doctor for you. Please stay by your telephon. When the office is closed, you can usually pageyour doctor. find out the number before surgery.Stay by the phone so your dcotor can reach you. If your emergency is life threatening go to your nearest emergency room. They will begin treatment and contact the doctor for you.