L brachioplasty correction of excess tissue of the upper arm, axilla, and lateral chest PDF20151228-31436-TKMBTG

Title	L brachioplasty correction of excess tissue of the upper arm, axilla, and lateral chest
Author	Dennis Hurwitz
Pages	10
File Size	410.6 KB
File Type	PDF20151228-31436-TKMBTG
Total Downloads	113
Total Views	188

Summary

131 CLINICS IN PLASTIC SURGERY Clin Plastic Surg 35 (2008) 131–140 L Brachioplasty Correction of Excess Tissue of the Upper Arm, Axilla, and Lateral Chest a,b, c Dennis J. Hurwitz, MD, FACS *, Tim Neavin, MD - Deformity - Discussion - Patient selection and goals - Summary - Operative technique - Ref...

Description

L Brachioplasty Correction of Excess Tissue of the Upper Arm, Axilla, and Lateral Chest Dennis J. Hurwitz, MD, FACS a,b, *, Tim Neavin, MD c The upperarm, axilla, and adjacentchestof a woman are appreciated for femininity,beauty, and erotic sensuality. As such,the excess sagging skin and fatin this area that commonly follows massive weight loss or aging is exceptionally annoy- ing.Although the most dramatic manifestation is the canopy-like draping between the axilla and the elbow, disturbing deformity sometimes extends distally onto the forearm but invariably includes the axilla and crosses onto the chest and lateral breast. These aficted women awkwardly cover up with long sleeves. They disdain sleeveless tops and bath- ing suits. Lateral skin rolls annoyingly overhang the top edge of their bra. Excessively deep and oversized armpits look bizarre and are difcult to shave. Brachioplasty is the plastic operation that treats this common condition [1–4]. By its most limited defnition, brachioplasty removes excess medial up- per arm skin and fat for esthetic reshaping. Patients with the moderate to severe deformity have taught us thatbrachioplasty should be expanded to in- clude the axilla and upper chest. The new contour throughoutthis region should be attractive, the scars inconspicuous,and complicationsminor and uncommon. Unable to succeed consistently with established techniques, the senior author developed a new ap- proach consisting of a continuous excision of excess skin from the arm through the axilla and onto the chest in the form of the letter ''L'' [5].Since 2001, this technique has met with consistent success in more than 50 patients, with only minor occasional complication. The ''L'' represents the shape of the excision, with the long limb along the medial axis of the upper arm and the short limb meeting at right angles across the axilla along the midlateral chest. The sweeping scar across the axilla resembles the letter ''L'' on its side. The L brachioplasty is de- signed for the perfuse weight loss deformity, but it can be adapted to the aging arm. This review of our experience describes the defor- mity,the marking, the execution, and the integra- tion of the L brachioplasty into upper body lift and breastreshaping surgery. Illustrativeresults are presented. The discussion elaborates on the ra- tionale and contrasts it with currentrecognized techniques. C L I N I C S I N P L A S T I C S U R G E R Y Clin Plastic Surg 35 (2008) 131–140 a University of Pittsburgh Medical School, Pittsburgh, PA b Magee-Women's Hospital, Pittsburgh, PA c University of Pittsburgh Medical Center, Pittsburgh, PA * Corresponding author. 3109 Forbes Avenue, Suite 500, Pittsburgh, PA. E-mail address: [email protected] (D.J. Hurwitz). - Deformity - Patient selection and goals - Operative technique - The operation - Discussion - Summary - References 131 0094-1298/08/$ – see front matter ª 2008 Elsevier Inc. All rights reserved. doi:10.1016/j.cps.2007.08.005 plasticsurgery.theclinics.com...