Arm lift

There are general complications and risks with all operations and procedures and your surgeon will ensure that you are fully aware of these and the more specific ones relating to your selected operation before you commit to surgery.

To help minimise all these risks, there are a number of positive things you can do and a number of things to avoid. We strongly recommend the following advice.

Do:

• Eat a balanced nutritious diet. Let the surgeon know if you are vegan. This is quite acceptable but we may suggest some blood tests and perhaps some nutritional supplements.
• Consider a standard vitamin supplement containing iron but only in the recommended doses. Beware of complex food supplements with uncertain contents.
• Take moderate regular exercise. Be fit, feel better and look better.
• Tell your surgeon if you are taking the contraceptive pill or oestrogen supplements before arranging your surgery. These can increase the risks of deep vein thrombosis.
• Be prepared to mobilise quickly after surgery, again to avoid deep vein thrombosis.

Do not:

• Take tablets or medicines containing aspirin, indomethacin or ginkgo biloba in the two weeks prior to your surgery or afterwards without discussing this in advance. This can result in a considerable increase in bruising and bleeding.
• Plan an overseas holiday just before your operation. Even a modest flight can increase the risks of deep vein thrombosis and there is always the risk of flight delays!
• For similar reasons do not plan a holiday immediately after surgery. We like to have you reasonably close by for a week or two.
• Sunbathe in the days immediately prior to surgery especially if you are having a facial operation. You will be swollen, red and more prone to bleed.
• Smoke. Be honest about this with your surgeon as this can greatly increase the risk of bleeding and skin loss. Cigarette smoke contains chemicals that cause spasm in small blood vessels. Even one cigarette, in the early postoperative period, can be critical.
• Drink too much alcohol in the days before your operation. A healthy liver means an easier anaesthetic and a quicker recovery.
• Use moisturising lotion or bath oil just before surgery. This interferes with our ability to accurately mark up and plan your operation.

Before undergoing this type of surgery, it is very important that you do not take Aspirin or rheumatic-type drugs like Brufen or Nurofen for at least a week before the operation. Should you currently be prescribed these drugs by your GP then please check with him/her whether you can stop taking these safely. These medicines alter the clotting of the blood and make bleeding after the operation more likely. Even one tablet can affect the clotting of the blood for up to ten days before an operation. It is also advisable to avoid Gingko Biloba products.

Patients on oral contraception and HRT should ideally stop for six weeks prior to surgery as there is an increased risk of thrombosis and start again six weeks after surgery. During this period alternative forms of contraception are required.

The hand can swell so it is very important you elevate the hand and wear any compression dressing provided

You will have dressings applied to the arm and scars after the operation to help take some of the tension off the repair. It is unlikely that we would need to use drains.

• If surgery is under general anaesthetic you will require a 1 night stay in hospital and you will experience some discomfort and bruising.
• Your upper arms will be dressed with micropore tape.
• The wounds will be inspected in clinic after one week and the tapes changed.
• You will be advised to walk around to help stimulate your circulation and thereby reduce the risk of blood clots. Your post-operative instructions will advise no lifting or straining until your arms are sufficiently healed.
• You will be provided with a compression garment which you should wear day and night for 4-6 weeks.
• Depending on your occupation you may consider returning to work in 2-4 weeks.
• You must also rest, so plan in advance and prepare by informing friends, family and work colleagues. You may also need home care post-op, so ensure you have reliable assistance close at hand as you recover.
• Any form of physical exercise should be avoided for the first 4-5 weeks. This includes housework (particularly that which involves the upper body), dog walking and repeated lifting of objects. Strenuous exercise should be avoided for 12 weeks after your surgery. This means no jogging, heavy housework, gym workouts and exercise classes.
• Scars will be prominent at first, and even worsen for anything up to six months before they fade to acceptable levels at around12-18 months. Again, this is normal with arm lift surgery.
• Once the wounds have healed sufficiently they should be massaged in the line of the scar twice a day for 5 minutes using an appropriate cream/oil. This should be continued until the scars have fully faded.
• Sunbathing/exposing the scar to direct sunlight is inadvisable for the first year. Sun block should be worn over the scars thereafter.

Depending on your job you can usually return to work for light duties after one week. No sport, strenuous exercises or weight lifting should be undertaken until six weeks following surgery.

An arm lift leaves a scar that runs from the armpit to the inner aspect of the elbow. It is quite a long scar and can be visible, but it has to be used in patients who have significant laxity of the skin.

Very occasionally another method can be used, which leaves a T-shaped scar that runs horizontally up in the armpit and a short scar down the inside of the arm. This is better hidden, but it does not allow us to remove quite so much from the upper arm. The scar usually settles and is hidden when you wear a short-sleeved top, apart from when the arms are up.

As with any operation, there are potential risks of infection, poor scarring and bleeding, though the risk of this is small.

Swelling can cause tingling in some nerves. If severe please report to us please.

The scars tend to become red, raised and itchy over a period of six to eight weeks and then should settle over the subsequent months. However, with all operations there can be problems with infection in the wounds and wound scar hypertrophy, when the scars become lumpy and may remain raised for up to eighteen months. The risks of wound infection are small (approximately 4%), but this is something you should bear in mind and if this occurs, the final scar may stretch.