Extended brachioplasty incision through posterior axilla, does it have an impact on final results? Our experience

Background: The aesthetic upper arm is characterized by a lean, tapering contour with anterior convexity from deltoid to biceps regions. Brachial deformities, including skin laxity with or without fat excess, often extend from olecranon to chest wall, resulting in increased inferior arm curvature. Brachioplasty procedures have increased dramatically in popularity, yet postoperative scarring remains patients' primary concern. This study evaluates the impact of extending brachioplasty incisions through the posterior axillary fold on scar quality and functional outcomes.Methods: This retrospective single-arm interventional study examined 40 female patients (aged 30-60 years) who underwent brachioplasty. All procedures utilized a standardized technique with incisions beginning above the elbow, extending to the axillary fold, and continuing through the posterior axilla. Patient satisfaction was assessed using a 5-point Likert scale. Complications and recurrence were documented at week 1, month 1, month 3, and month 6 postoperatively. Results: Mean patient age was 44.6±8.47 years with mean BMI 35.8±7.79 kg/m². The success rate was 92.5%, with 75% of patients reporting satisfaction or high satisfaction. Complications included hypertrophic scarring (27.5%), temporary numbness (15%), mild wound dehiscence (7.5%), and seroma (2.5%). Recurrence rate was 7.5%.Conclusions: Extended brachioplasty approach through the posterior axilla demonstrates promising results with a high success rate and satisfactory outcomes for most patients. While complications remain with limited incidence, particularly hypertrophic scarring, this technique provides effective aesthetic results with acceptable morbidity.