Monoblock Thoracobrachioplasty in Males: A Proposed Technique Mimicking the Pectoral Fold

Abstract

A growing number of men with massive weight loss are seeking improvement of arm deformity extending through the axilla and on to the chest. Although contouring techniques addressing the male arm and anterior chest deformities as separate entities have been described, when a combination of those techniques is performed, the surgical outcomes may lead to improper placement of the resultant scars. The authors propose an upper body-contouring treatment by monoblock thoracobrachioplasty aimed at correcting chest, axilla, and arm deformities in men through a single continuous incision, resulting in a thoracic scar placed right on the pectoral fold. The described surgical approach provides excellent chest contour and simultaneously addresses the upper extremity and axillary contour deformities in men after massive weight loss. The final position of the scar on the thorax corresponds to the inferior pectoral groove, resembling the division of two aesthetic units in the thorax and resulting in anatomically favorable scar positioning. A limitation of this proposed technique is the potential retraction of the axillary part of the continuous scar that may need revision. Careful preoperative evaluation and markings followed by intraoperative skillful handling are needed to prevent complications. The procedure appears relatively simple and easy to perform but requires a learning curve for previewing the ideal positioning of the resultant scar to obtain aesthetically favorable results. Monoblock thoracobrachioplasty mimicking the pectoral fold is a treatment option to be added to the armamentarium of techniques for postbariatric male patients.