FOLLOW INSTRUCTIONS GIVEN BY DR SOMIA CLOSELY
IF YOU HAVE ANY CONCERNS GET IN CONTACT VIA 02 9387 2110 OR AFTER HOURS CONTACT THE HOSPITAL YOU HAD YOUR SURGERY AT
IF YOU EXPERIENCE ANY OF THE FOLLOWING PLEASE GET IN CONTACT:
• Fever/chills (temperature higher than 38o)
• Heavy oozing/bleeding from the wound
• Increased swelling around the wound
• Increased pain
• Difficulty breathing or passing urine
• Spreading redness around the wound or foul odour
HOSPITAL PHONE NUMBER
Lakeview Private 02 8624 5000 or 02 8711 0736 (after hours)
Prince of Wales Private – 02 9650 4000
Norwest Private – 02 8882 8882
BASIC WOUND CARE
LEAVE THE DRESSINGS INTACT UNTIL YOU SEE DR SOMIA
If the dressings fall off and you have been given Chlorsig Eye ointment (also used in plastic surgery) apply to the suture line 3 times per day. If you are concerned about the appearance of the dressing, you can place another dressing on the top. Do not remove the dressing yourself. If the tape falls off use a similar tape or a bandaid.
You should expect that they could become warm and have a small amount of pressure. Occasionally, dressings can cause some irritation, and rarely cause allergic reactions. Should the dressings become unbearable or cause increasing redness and swelling, please call the office to arrange for them to be changed.
DO NOT GET THE WOUND WET.
You can usually shower fully after the post-operative visit. Until then use a handheld shower or sponge bath. If the tape gets wet pat it dry and let it air dry.
IF THE WOUND STARTS TO BLEED, SIT DOWN AND REST, APPLY GENTLE BUT FIRM PRESSURE FOR 5 MINS WITH THE PALM OF YOUR HAND.
Most bleeding will stop. If bleeding continues please contact us or the hospital (seek medical attention). If the wound is itchy, use gentle pressure with the palm of your hand, under no circumstances should you rub the suture line vigorously.
MEDICATIONS
Take your prescribed medications and analgesia such as Panadol. If you feel you need stronger painkillers contact our office. Antibiotics are not always necessary except in special cases. If you have been prescribed antibiotics take them as instructed. You can recommence your regular medications soon after your surgery.
ACTIVITIES AFTER SURGERY
- Avoid smoking/vaping as it delays healing and increases the risk of complications.
- Do not drive, work, act as a carer or sign important documents for 24 hours following anaesthetic. You may find you will need to have a rest in the afternoons following surgery. Check your motor vehicle insurance policy for any restrictions.
- If you have DVT stockings you can remove them when you return home.
- Stay well hydrated, eat well and nutritiously + take it easy for the next day or two.
- Only light activities are permitted until the first post-operative visit. No activities that increase your blood pressure or heart rate should be undertaken for 2 weeks. Walking normally is allowed. Avoid any activity that causes straining, coughing, lifting or stooping. Gentle walking and other light activities can be encouraged to promote circulation but avoid straining the surgical area. take short walks every few hours to lower the chance of blood clots forming in the legs.
- If possible avoid sneezing.
- Keep your head elevated at night and avoid lying on your side or face.
- Do not use makeup/sunblock over the raw suture lines until the wound completely heals (2-3 weeks)
ARMLIFT SPECIFIC INFORMATION
Avoid shoulder based activity for 6 weeks (including lifting moderate to heavy objects, pets or children, reaching for the top shelf, reaching cabin baggage, pulling luggage off the conveyor belt).
Safe driving does not involve significant shoulder movement and is permitted when you feel comfortable and confident.
However, getting in and out of your vehicle does involve shoulder movements that can affect your healing. It is recommended to avoid driving for 1-2 weeks whilst swelling and bruising subside. Check vehicle insurance policy for any restrictions.
Wear your compression garment for 12 weeks 24/7. If you feel continued pain/discomfort contact us or you have an accidental trauma or fall.
“Listen to your body”. If it hurts, your body is telling you something.
SWELLING AND BRUISING
The upper arm area may have some bruising, significant swelling, and tightness initially. Your hands may feel similar to boxing gloves. How long this lasts is different for everyone but the discomfort should gradually subside over the coming days to weeks but may last longer.
NERVE PAIN
Brachioplasty involves the excision of excess skin and fat, aiming to preserve all the deeper structures. Some of the nerves that supply sensation to the upper arm and forearm are within the fat that is excised.
Whilst we aim to preserve the nerves, they can sometimes be damaged during the operation. They generally recovery within a few months. Rarely, these nerves can be caught up in scar tissue and cause ongoing pain, despite the nerve itself not being damaged.
BLEEDING
There will be a small amount of bleeding or red discharge from your wounds in the first few days after your operation. Large amounts of bleeding should be treated by keeping calm (to lower your heart rate and blood pressure) using ice packs (to shrink the blood vessels) and applying constant gentle pressure to the area. If the bleeding does not stop within 20-30 minutes, you should call the rooms or go to the hospital. If an increase in bleeding is noticed at the same time as an increase in pain, you may be developing a haematoma and should contact the rooms or hospital.
Very rarely, bleeding after surgery requires a visit back to the operating room to drain the collected blood and control any bleeding vessels.
INFECTION
Infection is uncommon after elective plastic surgery. You will be given antibiotics through the drip during the operation and if there are any abnormalities noted during the operation, you will be sent home with tablet antibiotics for a week after the operation. Should an infection develop, it would usually begin at about the 5th to 10th post-operative day (around about the time that you are due to see us for removal of sutures and dressings). If you notice increasing pain, swelling and redness of the area that was operated on, please call the rooms or the hospital.
CHANGES IN SENSATION
Changes in sensation are impossible to predict. Most have a temporary decrease in sensation that returns to normal within a few weeks. It is uncommon to have long term numbness. As sensation returns to an area it is usual to experience some tenderness and itchiness.
HAEMATOMA AND SEROMA
Any operation in which there is a large surface area that is operated on runs the risk of having blood or fluid collect in the space left behind as it heals. We place surgical drains to prevent these collections of fluid, but they will occasionally arise after the drains have been removed or collect in an area that does not flow to the surgical drain. For this reason it is important to maintain constant pressure on the operated area (compression garment) to help prevent this from happening. Should a fluid collection occur it can be removed either with a needle aspiration, or occasionally another drain can be placed under ultrasound guidance.
SKIN CONTOUR IRREGULARITIES
Any operation that uses liposuction as a step in the process of thinning fat layers runs the risk of some contour irregularities especially in the case of lipoedema. These usually settle within a few weeks, and are assisted by wearing compression garments. Massage after a few weeks can also help smooth out small irregularities.
FIRMNESS
After any operation, as tissues heal there is some swelling/firmness. The majority will resolve within 6 weeks, but the last small amounts can take up to a year to completely resolve. One month after your operation, some gentle tissue massage will help speed the recovery of the tissues.
Occasionally, there will be patches of fat that has not survived the operation (fat necrosis) that become hard and need to be removed.
EXPOSED SUTURES
Many sutures (both permanent and dissolving) that are used to reshape tissues are buried within the soft tissues. Occasionally, these sutures will show themselves through the skin. If they become problematic, they may need to be removed. This is usually something that can be done in the office.
DELAYED HEALING AND TISSUE DEATH
The expected time frame of healing within is; skin should heal within a week and soft tissues around 6 weeks. Diabetics, smokers/vapers and people with some other diseases will have the risk that their tissues will take longer to heal and may have some tissue death before healing. Operations with more aggressive liposuction and tight closure are also predisposed to increased healing stress, and therefore more risk of wound problems. Most of these problems can be managed with appropriate dressings but may need additional surgery.
DOG EARS AND ADDITIONAL SKIN FOLDS
Depending on the technique utilised, as compared to the skin excess in all dimensions, there may be some excess skin folds at the end of your operation. These generally improve with time, but if they persist for longer than 4 months a touch up procedure may be required.
LONG TERM ASYMMETRY
Small asymmetries should be expected. As the swelling subsides over the first 6-12 months, there will be different parts of your operation that you are more or less happy with. You should allow at least 6 months to settle out minor asymmetries. Major asymmetries will be adjusted by your surgeon.
SCARS
Depending on your needs your surgeon will suggest a technique (or pattern) they believe will provide you with the results you are after. This is not a hard and fast rule and there is some room for discussion taking into consideration the importance that you place on length and position of scars and the need for further touch up procedures.
LYMPHOEDEMA
This is a complication in which there is persistent swelling after the operation due to the disruption of the normal channels that drain extra fluid from the tissues. Changes in size and shape As brachioplasty surgery reshapes normal tissues, any weight gain or loss will be reflected in the size and shape of your arms. Because of this, we ask that your weight be fairly stable for about 6 months (or 2 years post bariatric surgery) prior to undergoing this operation to ensure that your results will last as long as possible.
IN THE EVENT OF A COMPLICATION
We will support you throughout. Contact our office with any concerns. In some circumstances additional testing, post operative wound care, medications or surgery may be required and/or referral to another specialist. Rest assured we will support and assist you.
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