My arm looks awful after brachioplasty

Personally, I would much much rather have my arms done twice with a revision to get them tighter THAN have a complication as yours.  But that is just my own opinion.  You will most likely need a revision to get the scar to look better.  Perhaps not, if you're very fortunate and heal well.  I'm sorry you have had to deal with this, I know every surgery has it's risks.  I had 5 lbs of excess skin removed from my arms and had no complications.  I'd much rather have the long scar than the excess skin, anyday.

I'd have to agree with you there I-Am. I'd rather have a little "droop" and then come back a second go round "if" I felt that I needed it tighter, than to be dealing with necrosis, possible infections, and in the very very worst case scenario - loss of a limb.  No amount of vanity or self esteem boosts is worth that in my opinion.

As a matter of FACT, I can even up the ante and say that IF I knew for a fact that my arms would look like the pictures shown in this thread, I'd venture to leave my arms just the way that they are, and wear long or 3/4 length sleeves for the rest of my life.  I'm serious. 

Frankly, those pictures have me traumatized. I've worked in the medical field for many years, but I did not do "wound care".  So I'm a bit freaked. I'm not sure why the OP continues to relentlessly defend this surgeon's work. I understand that when folks vest energy and have faith in their surgeon, then it's tough to acknowledge when the surgeon  make obvious misjudgments and flaws. However, rather than to relentlessly defend the surgeon, I'd rather "sit back" and see what all happens, - I mean study how this thing all pans out and get's resolved. Doctor's can make "promises of future revisions" until they are blue in the face. But what about now? What about the pain and the limited range of motion that I'm suffering from now? What about the stress on my family and additional responsibilities that they are stuck with now?  What about the fact that I can't comb my hair, or groom myself well now? What about the possible physical therapy and the copayments and gasoline that I may have to spend and possible time off from work now? What about my worry and anxiety now? What about all of that now? No way in hell that I would be ranting and raving about this doctor now. Until everything was COMPLETELY resolved. That's my 2 cents here. 

We can not expect to have "perfect" bodies after what we have all been through. What we can /should expect is to have some reasonable degree of improvement, and to walk away from the procedure pretty much "intact". At least that's how I see it in my book. No offense meant to the OP, but you asked me to state my thoughts from yesterday. Here are "some of " my thoughts. Also on RealSelf there is another member who's arms pretty much look almost the same way, from the same surgeon SMH. 

Hope you get better as each day goes on girl! 

Oh, I just saw your post now when I was looking through this thread. I am not receiving notifications all of the time when people reply to me.

I am not offended by your candid post at all. In fact, I appreciate your candor. And I am reconsidering my position. I think that maybe I would rather need a revision surgery to remove more skin than to go through this, as long as I was having another surgery with the doctor. Because otherwise OR fees and anesthesia are very expensive. That said, this is not a good situation that I am in. 

I was told by a plastic surgery PA that this sort of thing happens all the time. But I have never seen it and I have been up to my eyeballs in plastic surgery sites like OH and RS for the last 7-mos. I know the axilla open, most of Dr. C's patients that I know do have their's open. But I've never seen them not heal and I've surely never seen an arm wound like this. I think it is not common because Dr. Capella did not discuss this complication as a possibility. On the other hand, my PCP did not say anything different from what Dr. Capella told me, aside from recommending that I do a saline wash. So that is three healthcare professionals (including Dr. Capella) telling me this is nothing to worry about. Would three healthcare professional be wrong? What would you do if you were in my position?

My arms are worse this morning than they were yesterday, at least as it appears to me. I've pasted the pix below so you be the judge. I am feeling very discouraged at this point. I am not healing. I have limited range of motion. I am confused by the conflicting information and directions I am getting from my surgeon. I now feel that he is distracted and not paying attention to details. I sent these pix to Dr. Capella this morning (11/14) and he replied that I have hyper granulation and he will send me nitrate sticks. But I told him 10 days ago that I had hyper granulation and we talked about the nitrate sticks but he never sent them. So I phoned him today at 2:30pm and to make matters worse he did not return my call.

I am not going to waste anymore energy defending Dr. Capella on this community. It is too time-consuming. All of you are adults who will form your opinions and I have no control over what you think or post. Nor would I want to have. So I will continue to report on my experience, but not rave about my doctor. And as for why I relentlessly defended him, both publicly and privately on many occasions, is 1) I believed in him and 2) I did not want the relating of my experience to tarnish his reputation for something that is not his fault.

You bring up many valid concerns. Maybe I have just been too nice. 

Right arm close up 5 weeks PO

Right arm 5 weeks PO

Left arm 5 weeks PO

Wow girl so sorry. Although I definitely see a "change" in the way that your arm looks in these pictures. I'm not really encouraged at this point that it's necessarily getting better.  Since you have already seen your PCP. The ONLY other thing that I myself would do (because I am a big time scaredy cat), is to request that your PCP refer you "in plan" to a plastic surgeon just for a "consult". This way, you have EYES on this wound from someone who actually preforms those types of surgeries. I guess if there is no infection, and if there are "some" signs of healing, then I would try and stay positive. I'm not very familiar with nitrate sticks, but if they are supposed to work , then perhaps I'd wait until I applied them before seeking out the 2nd opinion PS consultation. But I tell you this much...Today is Friday morning, by MONDAY, if I did not see an improvement, I'd definitely see another plastic surgeon. 

I am waiting until Wednesday, when I have my 6 week follow up with Dr. Capella. I have no interest in seeing a plastic surgeon locally. I had a very bad experience after my tummy tuck. 

I manually pulled off some of the debris from the arm wound this morning. Blech. I feel like I am having wound healing issues... I do not know if thwt is clinically correct... I do have diabetes type 2 but it is in remission for the last decade since my RNY. I have never had healing issues before and I just keep wondering if somehow that plays a role or if it just drew the short straw this time.

**** happens.

Don't pick at them, I get it I am a picker also but stop, that isn't going to help anything.  Just leave it be and let it heal, honestly stop looking at it.  Are you wearing some sort of sterile garment on them?  If not get one and leave it on and just let a few days go by before you keep checking them, I think you are healing but its a really big deal for your body to heal all that and the other stuff at the same time.  You aren't going to be healed by a date on the calendar, it doesn't work that way.  I remember when I had the chicken pox 10 years ago, I had one pox mark in the middle of my stomach, I swear it took 6 months to heal when everything else was a distant memory, our bodies are gonna do what our bodies are gonna do.

Dr. Capella likes the rough weave gauze because it sticks to the debris and pulls it out. Hey, you have to be pretty tough to have surgery with this man! Anyway, I could not get the rough weave at the pharmacy so I removed the debris that was loose with my fingers. It will not stick to the fine weave gauze that I have. I ordered some new gauze from Amazon and hope it is the rough weave... it was the same manufacturer that Dr. Capella used and based on the low price I assume it is rough weave. I find that my arms seemed to heal better when I simply used the rough gauze and kept them dry, which is what he had asked me to do.

I am using sterile gauze. 

You know, I keep forgetting that my body had a ton of trauma inflicted on it. I keep wondering why the heck these arms are healing so slowly, and what you state makes perfect sense. All my little white blood cells and their buddies have a lot to repair! 

I just have to say that I went to Loft yesterday to cheer myself up after my darn arms had me so upset. And I was thrilled to death with the outfit I bought. A size XS sweater dress and size S leggings. The young and thin sales girls told me how great I looked in the outfit. I never heard that before I had plastics, LOL! Now I hear it all the time. I also was thrilled that I fit into size 4 jeans. I did not buy them though. I am not making the same mistake taht I made last time buying clothes too soon after my tummy tuck that now no longer fit. I will wait until I am 4-mos post op. I figure the leggins and sweater dress will stretch so it will work with whatever my final shape is... even if I get implants next year, LOL. Oh, and everything at Loft was 40% off!!!

I will never agree about not having a compression or protection garment for your arms, picking the stuff out risks infection and further wound opening.  Seriously ignore your quack doctor and use common sense, if his approached worked so well why aren't they healed, why did this happen in the first place.

Enough about that on to the great part, you are tiny now and can where anything you want, that is fun, you don't have to hide or tuck anymore.  Yeah!  Enjoy!

Thanks for making me laugh! I do not think you will ever be a fan of my surgeon. LOL 

I think it is possible that a compression sleeve may have prevented the arm sloughing, but Dr. Capella said he did not think so, so maybe not. I don't know jack sh*t about this topic. I know the cells dying is from a lack of blood supply to those skin cells but have no idea what causes that to happen. He said something about pulling me so tight. As for the cause of delayed healing he told me "I don't know." He is a man of few words... great listener, though.

A P.S. on RealSelf advised me of the following. It is not any different from what Dr. Capella or my PCP has told me. Chillax woman, I will be fine!! (((hugs for caring so much)))

Local wound care until it heals is the best option at this time. As the swelling resolves, your discomfort and range of motion should improve significantly. Most patients underestimate the time it takes to recover from an arm lift. If this is not the case by month three I would discuss the matter further with your surgeon.

I am feeling so deflated now, like I am beaten, and I feel I cannot keep up this positive attitude when the right side of my body has me concerned. I hope that I am having a bad day/night, but what is going through my mind now is who sewed the right side of my body? The right arm has that wound, the right leg has limited ROM because the skin is tight, the right thigh incision is not at all straight, the right groin and right axilla opened, and the right back incision is higher than the left side. Add to that both arms have limited ROM. 

I am very unhappy right now. I have to snap out of this. I feel emotional hunger beckoning me to soothe myself.