Long-term outcomes and complications associated with brachioplasty: a retrospective review and cadaveric study

To determine the overall complication rates associated with brachioplasty, a retrospective review was performed of all brachioplasty procedures performed at the authors' institution over a 16-year period.

Hospital charts were reviewed for patient demographics. Ten fresh frozen cadaveric arm dissections were performed to better evaluate the anatomy of the medial antebrachial cutaneous nerve as it relates to brachioplasty.

Forty bilateral brachioplasties were performed over the 16-year period. Average patient age was 47 years, and all patients were women. Average length of follow-up was 50 months. The revision rate was 12.5 percent. The overall complication rate was 25 percent. Ninety-five percent of the complications were classified as minor. None of the complications required correction with surgery. Complications noted were seroma, hypertrophic scarring, cellulitis, wound dehiscence, subcutaneous abscess, and nerve injury. Two patients (5 percent) developed an injury to the medial antebrachial cutaneous nerve during the procedure. Nerve injuries were classified as major complications. In cadaveric studies, the medial antebrachial cutaneous nerve was found to penetrate the deep fascia of the forearm at 14 cm proximal to the media epicondyle.

Brachioplasty can be performed with a very low incidence of major complications, but both surgeon and patient should be aware of the possible risks associated with brachioplasty. Cadaveric dissections revealed that the medial antebrachial cutaneous nerve lies within the plane of dissection of the standard brachioplasty technique and is therefore at risk of injury.