This is the only procedure that definitively transforms heavy, saggy upper arms.
Brachioplasty is a surgical procedure intended to remove excess skin and improve the contours of the upper arm and axilla (armpit) areas. Loose, heavy upper arm skin can be the result of weight loss or aging but can also be hereditary. Upper arm skin is not as elastic as other areas of the body and as we age, it is common to experience varying degrees of drooping skin under the upper arm. Particularly after significant weight loss, this extra sagging is exacerbated and causes what is sometimes referred to as a “bat wing” from the elbow to the armpit, or axilla.
The length and exact shape of the brachioplasty incision will be determined by the location and amount of excess skin. An arm lift is not a substitute for weight loss or exercise. To obtain the best results, those planning to lose weight should be close to their target weight before having this surgery.
Individuals who are not good candidates for an arm lift include those who have had a mastectomy (with removal of lymph glands). Diabetics and smokers are not necessarily excluded from having this surgery, but must weigh the increased risk of complications. Gastric bypass patients should consider postponing this surgery until weight is stable for one year.
After brachioplasty, an immediate improvement in the shape of the arms will be evident. Final results vary person to person, usually 3 to 6 months following surgery. The results after brachioplasty can be long lasting if a balanced diet and exercise program are followed.
Priorities
During consultation, the upper arms are examined in several positions. Skin tone and the degree of loose skin will be assessed. An arm lift is commonly performed in conjunction with liposuction of the upper arm for purposes of contouring. Typically scars extend from the armpit to the elbow on the inside of the arm. Meticulous technique and attention to symmetry are of utmost importance. There are shorter scar options possible that limit the scar to the armpit, but the correction is significantly less and suited only to mild conditions. The scars from a brachioplasty vary a great deal. In general, most patients heal well.
Liposuction alone may be effective if skin elasticity is good. A quick way to determine if you may need a brachioplasty is to hold your arm straight out then bend the elbow to 90 degrees. If there is more tissue below the bone in the upper arm than there is above the bone, then an arm lift may be the only recourse.
Non-invasive techniques like Ultherapy (ultrasound) or Forma Plus (radiofrequency) can be used to firm up the skin however they are intended only for mild tightening of the arm skin and improvement of the condition of the skin itself.
Hirmand Technique
My technique for a successful outcome when performing an armlift consists of:
- Meticulous dissection and precise closure
- Employing liposuction when needed
- Keeping the scarring to a minimum.
The incision allows removal of the excess skin. My technique emphasizes suspension of the supporting structure called the fascia, in order to support the arm, and minimize the risk of recurrent laxity. It also includes liposuction where necessary for an optimal outcome. After the fat and skin are removed, the incision is closed in layers to keep scarring minimal. The most important aesthetic consideration is to minimize scars and keep them as symmetric and as short as possible.
Surgical notes
Anesthesia: general (post-surgical pain pump available)
Length of surgery: 3-4 hours
Outpatient/inpatient: outpatient
Adjunct procedures: liposuction
Recovery: 7-10 days