A new study suggests brachioplasty complication rates are lower than previously reported. The most common major complications from the popular surgery to correct upper arm ptosis are hematoma and infection, according to the study published online May 23, 2016 in the Aesthetic Surgery Journal.
Researchers conducted a prospective, multicenter database study on the incidence of major complications and risk factors from brachioplasty using data from 2,294 brachioplasty patients in the CosmetAssure database. CosmetAssure is a Birmingham, Ala.-based complications insurance company.
They looked specifically for major complications, which the researchers defined as one requiring an emergency room visit, hospital admission or reoperation within 30 days of surgery.
They found brachioplasty patients represented 1.8% of the 129,007 patients enrolled in the CosmetAssure database. Major complications occurred in 3.4% of the brachioplasty patients studied. Infection represented 1.7% and hematoma 1.1% of those cases, according to the study.
Patients who had combined procedures were more likely to suffer a major complication, at a rate of 4.4%, versus the 1.3% major complication rate when brachioplasty alone was performed. Another independent risk factor for complications was having a BMI of 30 kg/m2 or more. Men were more likely than women to experience hematoma formation.
These rates are lower than previously reported, the authors write.
In June 2006, researchers reported in Plastic and Reconstructive Surgery on a retrospective review and cadaveric study of brachioplasty procedures performed at Mayo Clinic over a 16-year period.
Looking at an average follow up of 50 months, the researchers found the revision rate was 12.5% and the overall complication rate was 25% (although 95% of the complications were considered minor). The complications — none of which required surgical correction — were seroma, hypertrophic scarring, cellulitis, wound dehiscence, subcutaneous abscess and nerve injury, according to the study.
These researchers classified nerve injuries as major complications, reporting that two patients, or 5%, developed injury to the medial antebrachial cutaneous nerve.
In a later study published in Plastic and Reconstructive Surgery, published in April 2013, researchers conducted a multi-practice review of brachioplasty outcomes. They found that among 96 patients, 17.7% had major complications and 44.8 percent had minor complications. The revision rate in that cohort was 22.9%, with the most common reason being residual contour deformity. Unlike the new study in Aesthetic Surgery Journal, these researchers did not find an association between a higher complication rate and additional procedures performed at the time of brachioplasty.