Brachioplastic Positioning of the Scar to Optimize Final Contouring Results

Introduction: Brachioplasty is a surgical procedure aimed at removing excess skin and subcutaneous fat from the area of the upper arm. In some cases, mainly in patients after massive weight loss, the excision could also target the lateral chest area and/or to be extended further into the forearm area. Materials and Methods: A retrospective analysis was conducted on 22 patients who underwent different types of brachioplasty. Demographic and surgical data were collected and analyzed for potential factors influencing outcome. Results: In this group of 22 patients, 20 were female and 2 were male. In the subjective satisfaction score (1 representing the lowest satisfaction score and 5 representing the highest score) measured 12 months after surgery, 16 patients indicated the maximum value of the scale. Six patients indicated levels of satisfaction 4. The main improvement of the pinch test was calculated as 3,5cm in the 12thpost-operative month. Among the 22 patients included in this subgroup analysis, 6 (27%) experienced minor complications, all of which were resolved without requiring surgical intervention. Female patients belonged to the age range of22 to62 years, with an average age of 42 years and an average BMI of 26.5. All female patients underwent classical type of brachioplasty or L-type brachioplasty. Ten out of twenty female patients underwent soft tissue excision on the upper arm with extension to the lateral chest area. The two male patients were aged 28 and 50 and had an average BMI of 25. One of the male patients had L-type brachioplasty with extension on the lateral chest and flank area. The most common adverse event was wound dehiscence, managed successfully with secondary intention healing. Conclusion: Brachioplasty techniques have been used in male and female patients. In patients with predominant skin excess, excisional surgery with positioning the scar in the bicipital groove led to optimal results and “hidden scar”. An additional liposuction could be needed as part of the overall procedure for patients with skin and fat excess. In the second type of patients, posterior positioning of the scar led to levels of satisfaction 5, however, the scar was still visible. Positioning the scar in between the posterior surface and the bicipital groove in combination with liposuction would have achieved optimal results with less visibility of the scar.