Scar placement is important for more reasons than just to be “not as visible”. It is important that the Z-plasty part of the scar is well placed in the axilla so that no axillary contracture is formed. This can limit shoulder/arm motion. Good scar (incision) placement decreases the risk of injury to the cutaneous skin nerves, so there will be less chance of postoperative skin numbness.
Scar placement is usually either in the bicipital groove or more posterior at the most inferior point of the upper arm while it is raised and abducted (positioned away from the body). The second choice is less visible in everyday activity. Either way, the scar is there. The scar can be quite apparent, so this procedure should never be undertaken if the patient is not willing to make this trade-off (less skin, but a significant scar). Pre and Post-operative photos here.
- The L Brachioplasty: An Innovative Approach to Correct Excess Tissue of the Upper Arm, Axilla, and Lateral Chest; Hurwitz, Dennis J. MD, Holland, Sarah W. MD; Journal of Plastic & Reconstructive Surgery;Vol 117(2):403-411, February 2006.
- A Technique of Brachioplasty; Strauch, Berish MD, Greenspun, David MD, Levine, Joshua MD, Baum, Thomas PAC; Journal of Plastic & Reconstructive Surgery;Vol 113(3):1044-1048, March 2004.
- Textbook: Body Contouring After Massive Weight Loss by Al S Aly, MD
- Shaping Futures Web Site (you must register for access to the procedures)