Beni-Suef Faculty of Medicine, Egypt
Title: Brachioplasty for arm ptosis with severe fat deposit versus arm ptosis with minimal (or no) fat deposit; A comparative study
Biography: Rimon Boshra Rizk
BACKGROUND: Brachioplasty is a great way to achieve improved contour in the arm with a growing number of patients undergoing this procedure. (Shermak, 2011) Aim: The authors analyzed data from a retrospective and prospective study to compare the results of different techniques of brachioplasty in treatment of stage III and IV of brachial dermolipodystrophy according to El Khatib(2007)
METHODS: Twenty patients underwent brachioplasty with different techniques and assessment was done for selection of technique, hospital stay, complications, nerve injury, circumferential measurements improvement, skin quality, scar and finally patient’s satisfaction.
RESULTS: Twenty female patients (fourteen stage III & six stage IV) with mean age of 34.5 years underwent brachioplasty. Techniques used and the mean percentages of circumference reduction in proximal, middle and distal arm thirds are as follows: for stage III a)Minibrachioplasty plus liposuction (2 pts) ( 15.1 - 17.9 - 10.2%), b)Bicipital-groove brachioplasty plus liposuction (2 pts) (18.6 – 21 – 13.8%), c)L-brachioplasty (2 pts) ( 22.9 – 19.7 – 14.2%), d)L-brachioplasty plus liposuction (2 pts) (21.9 – 19.3 – 12.9%), e)Fish-incision brachioplasty plus liposuction (1 pt) (21.1 – 19.8 – 8.1%), f)Liposuction only (5 pts) (15.2 – 13.2 – 16.4%) while for stage IV are g)Bicipital-groove brachioplasty (3 pts) (21.3 – 21.2 – 15.1%) and h)Double-ellipse brachioplasty (3 pts) (32.2 – 36 – 25.8%). All patients spent 1 night at hospital. Complications occurred are oedema (20), cellulitis(1), delayed healing (3), superficial wound infection (2), allergic skin maceration (5) and mild contour irregularity (5). No nerve injury occured. For stage III patients, scar is rated as Excellent in 3 patients (21.4%), Good in 7 patients (50%), fair in 3 patients (21.4%) and poor in 1 patient (7.2%). For stage IV patients, scar is rated as Excellent in 1 patient (16.7%), Good in 3 patients (50%), fair in 1 patient (16.7%) and Poor in 1 patient (16.7%).Mean satisfaction for contour, symptoms, scar and overall satisfaction for stage III patients is (3.8 – 4 - 3.65 - 3.8) and for stage IV patients is (4.5 – 4.5 – 3.7 – 4.25)
CONCLUSION: In a brachioplasty for a fatty arm, liposuction may be performed in a separate stage months before excisional procedure or may be done simultaneously at the same session. Performing the procedure on an arm with less fat gives better results in contour improvement, symptomatic relief, but with longer scars which may annoy the patient. The overall procedures were tolerated well by the patients with acceptable complications.