Background and objective.

The constant rise in consultations for brachial flaccidity has generated a growing interest in perfecting the technique to avoid the frequent complications and unsatisfactory results.

Our objective is to describe a variant of the of T-brachioplasty surgical technique based on a deep and resistant anchorage as an alternative to diminish scar complications and to analyze outcomes.

Methods.

Retrospective, observational and descriptive study that included 15 patients with brachial flaccidity grades IIIA, IIIB and IIIC according to the Appelt´s classification from June 2015 to June 2019

The design of this surgical variant includes a T-shaped incision with an area of deep de-epidermization of at least 1 cm width surrounding the incision that will act as dermal anchorage, facilitating closure and providing a better plane of resistance than the techniques previously described, which will decrease the rate of subsequent scar complications (postoperative dehiscence and non-esthetic scars).

Results.

All patients were female patients, 47 years old average. The most frequent cause of flaccidity was aging (60%) and post-obesity weight loss (40%); the IIIA grade of flaccidity was 66% (10 cases), the IIIB grade was 13% (2 cases), and the IIIC grade was 20% (3 cases).

Surgical technique used in every case included a de-epidermization area of at least 1 cm surrounding the incision that acted as dermal anchorage at the time of closure.

The procedure was well tolerated in every case. General complication rate was 20% (3 patients): 13% (2 patients) presented a dehiscence at the central T stitch and 6.6% (1 patient) developed hypertrophic scars. One patient (6.6%) required a surgical revision.

Conclusions.

Dermal anchorage is a tool of great value at the time of providing support in an area that lacks support structures. We recommend using this tool whenever possible considering it is easy to perform, does not demand longer surgical time, facilitates closure and reduces scar complications.

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