Table 2.
Overview of studies on brachioplasty
| Author, year | No. Pts | Location | Demographic data | Brachioplasty surgical technique | Follow-up | Complications (pt=patient; pts=patients) |
|---|---|---|---|---|---|---|
| Lockwood T, 1995 (13) | 5 | USA | Not specified | Fascial anchoring | 6-12 months (average: 8 months) | Under-resection (1 pt) Small distal seroma (1 pt) |
| De Souza Pinto EB, 2000(16) | 20 | Brazil | Female (40-60 years) | S-shape (with or without liposuction) | 24 months | Hypertrophic scarring (2 pts) |
| Richiards ME, 2001 (17) | 9 | USA | Female (25-75 years) | Minimal-incision brachioplasty | Not specified | Skin wrinkling (1 pt) |
| Pascal JF, 2005 (37) | 21 | France | Not specified | Single ellipse with liposuction (resection only of the skin layer) | Not specified | None |
| Hurwitz DJ, 2006 (21) | 24 | USA | Female | Inverted L-shaped | 6-28 months | Delayed healing at the tip of the triangular flap due in part to pressure from elastic sleeves (3 pts) Seroma near the elbow responded to multiple aspirations (4 pts) Hypertrophic scar (1 pt) |
| Knoetgen J 3rd, 2006(38) | 40 | USA | Female Average age: 47 years (20-61 years) | Resection of medial upper arm skin and subcutaneous fat, placing the scar in the intermuscular septum. (7.5% of pts had simultaneous arm liposuction) | Average 50 months | The overall complication rate was 25%. Seroma (4 pts) Hypertrophic scar (4 pts) Cellulitis (3 pts) Wound dehiscence (3 pts) Subcutaneous abscess (1 pt) Medial antebrachial cutaneous nerve injury (1 pt) Medial antebrachial cutaneous nerve injury (1 pt) |
| Cannistra C, 2007 (34) | 50 | France | 25-60 years | It was applied an algorithm for marking a surgical plane to avoid postoperative arm asymmetry and to reduce surgical complications | 12 months | Large scars (20% of pts) |
| Wolf AM, 2007 (31) | 7 | Germany | Female | T-type brachioplasty | Not specified | In one patient, a neurolysis of the ulnar nerve became necessary due to postoperative edema |
| El Khatib HA, 2007 (1) | 60 | Qatar | 24-56 years | 7 pts (stage 1 brachial ptosis): circumferential liposuction 13 pts (stage 2a brachial ptosis): staged circumferential liposuction 12 pts (stage 2b brachial ptosis): liposuction of the lower posterior and medial arm assisted short longitudinal scar brachioplasty 17 pts (stage 3 brachial ptosis): liposuction of the lower posterior and medial arm assisted short longitudinal scar brachioplasty 11 pts (stage 4 brachial ptosis): traditional brachioplasty |
12-38 months | None Postoperative brachial ptosis (1 pt) None Hypertrophic scar (1 pt) Distal edema (1 pt) Postoperative skin laxity in the axillary region (2 pts) Distal edema (1 pt) |
| Gusenoff JA, 2008 (39) | 101 | USA | 97 female, 4 male. 45110.1 years | Brachioplasty (inverted L-shaped) alone or in combination with other procedures | 6 months - 2 years | 36 pts had complications related to their arms Seroma (24 pts) Dehiscence (9 pts) Infection (3 pts) |
| Migliori FC, 2009 (36) | 29 | Italy | Female Average age 41 (35-48 years) | Personal technique based on a careful preoperative evaluation and markings, followed by an intraoperative skillful handling | 6-36 months | Scar Hypertrophies/keloids (12 pts) Edema (4 pts) Seroma (3 pts) Section of cutaneous branches of the anterior medial brachial nerve (2 pts) Ulnar nerve compression (1 pt) Wound dehiscence (1 pt) |
| SymbasJD, 2010 133) | 31 | USA | Not specified | Inverted L-shaped (16 pts) and double ellipse (15 pts) | 2-42 months (average: 16 months) | Hematoma (2 pts) Lymphocele (2 pts) Revisions: dog ears (2 pts) Cellulitis (1 pt) Infection (1 pt) Delayed healing (1 pt) scar contracture (1 pt) Scarring (1 pt) Re-excision (1 pt) |
| Nguyen AT, 2010 140) | 21 | USA | 35-59 years | Posterior Brachioplasty Liposuction-Assisted (elliptical incision) | 3 months - 3 years | Small wound dehiscence (2 pts) Slightly hypertrophic scar (1 pt) |
| Modolln ML, 2011 130) | 18 | Brazil | 49.2±11.3 years | Fish-incision 19 and, in cases of excess skin extending to the lateral chest wall, the skin fragment excision was prolonged towards that direction, with the aid of a Z-plasty | 6 months | Seroma (1 pt) Damage to the medial cutaneous nerve of the forearm (1 pt) Scar imperfection (1 pt) |
| Aboul Wafa AM, 2013(23) | 18 | Egypt | Female | S-shaped | 3-24 months (average: 11 months) | Seroma (1 pt) Scar hypertrophy (1 pt) Contour irregularities (1 pt) |
| Bossert RP, 2013 135) | 144 | USA | 139 female, 5 male | Sixty-four patients had concomitant arm liposuction at the time of brachioplasty. The remaining 80 patients underwent excisional brachioplasty alone | 6-24 months | Overall complication rate: 46%. No significant differences in complication rates were seen between the liposuction and excision-alone cohorts for seroma (19.1 percent versus 23.1 percent), wound dehiscence (7.9 percent versus 2.6 percent), infection (4.8 percent versus 6.4 percent), hematoma (3.2 percent versus 0 percent), or lymphedema (3.2 percent versus 1.3 percent). Revision rates were similar between the two groups (9.5 percent with liposuction and 8.9 percent without liposuction) |
| Bracaglia R, 2013 (24) | 41 | Italy | Female Mean age: 47 years (39 ± 10 years) | "Kris knife" technique (because of the incision similarity to the wavy blade of the Asian dagger kris) | 36 months | Delayed healing (4 pts) Seroma (1 pt) Hypertrophic scarring (2 pts) |
| Elkhatib H, 2013 (41) | 205 | Qatar | 21-66 years | Posterior Scar Brachioplasty with Fascial Suspension | 29-98 months | Hypertrophied scar (5 pts) Postoperative distal edema (3 pts) Dysesthesia due to skin tightness (1 pt) |
| Zomerlei TA, 2013 (42) | 96 | USA | 95 female, 1 male Average age: 51 years (26.5-76.5 years) | Single ellipse (75 pts) Fish mouth (14 pts) l-pattern (5 pts) Z-plasty (2 pts) | Not specified | Total complication rate was 53.1% (51 pts) Hypertrophic scarring (23 pts) Seroma (6 pts) Dehiscence (6 pts) Hematoma (2 pts) Stitch abscess (5 pts) Infection (14 pts) Revision (12 pts, 12.5%) |
| Fantozzi F, 2014 (26) | 23 | Italy | 20 female, 3 males Median age: 55.4 years (36-77 years) | Brachial lifting using the balanced triple-vector (BTV) technique with dual opposing flaps | At least 20 months | Temporary paraesthesia (5 pts) Temporary loss of sensation (2 pts) Temporary swelling of hands (2 pts) Seroma (1 pt) Scar revision procedures (2 pts) Patient unsatisfied with final scar quality (1 pt) |
| Kornstein AN, 2014 (27) | 1 | USA | 46-years-old female | Silk-derived surgical scaffold (SERI) as an adjunct to conventional brachioplasty | 6 months | None |
| Hurwitz D, 2014 (32) | 1 | USA | 33-years-old female | Inverted L-shaped | 3 months | Dehiscence (2 cm, along the apex of the right axillary closure) |
| Knotts CD, 2014 (25) | 44 | USA | Female Average age 53 years (33-75 years) | Avulsion brachioplasty | average: 446 days | Wound dehiscence (14 pts) Seroma (1 pt) Widened/hypertrophic scar (9 pts) |
| Han HH, 2014 (29) | 1 | Korea | 31-years-old female | Traditional brachioplasty (single ellipse) | Not specified | None |
| de Runz A, 2015 (43) | 24 | France | Mean age: 44.4 years | Liposuction-assisted medial brachioplasty (single ellipse) | There were 10 patients (41.7 percent) with at least one complication Revision scar (1 pt) Paraesthesia (1 pt) Second operation for scar correction (4 pts) Under-resection (2 pts) Wound dehiscence (3 pts) Bad scarring (hypertrophy/widening) (6 pts) |
|
| Ferraro GA, 2015 (28) | 30 | Italy | Female Average age: 51 years (45-58 years) | Modified fish-incision | 1 year | None |
| Thawani SP, 2015 (44) | 1 | USA | 49-years-old female | Liposuction and brachioplasty | 10 months | Significant right partial proximal median neuropathy Mild right ulnar neuropathy Left medial antebrachial cutaneous nerve neuropathy |