Arm Lift / Brachioplasty
by Saul R. Berger, MD, FACS
One of the most common procedures patients seek after weight loss is contouring of the arms. This procedure can be life changing for many individuals who are unable to wear short-sleeve or sleeveless attire, or even knock things over if they have severely lax skin. There are a number of possible approaches that can be used; the best approach must be individualized for each candidate. One of the key factors in establishing a plan depends on the amount of excess fat as well as the laxity or looseness of the skin. If the skin is not very loose and has the probability of tightening up as the fat is reduced, then approaches such as liposuction can improve the contour with the most minimal or inconspicuous of scars. If the skin is very loose, the chance of it tightening after fat reduction is very low and, consequently, the skin generally needs to be tightened surgically using lengthier scars.
Patients considering brachioplasty are often very concerned about the scars, and justifiably so. For those with loose skin, the removal of the excess can be thought of as a “tradeoff” between greatly improved contour and a visible scar. There is some latitude as to where the incisions can be located in planning the surgery, and your surgeon should discuss this with you. In particular, your surgeon should discuss the advantages and disadvantages of placing the incision in specific parts of the arm. Most of my patients tend to select an incision that is not visible when the arm is held naturally at the side of the body. In such cases, if one were to extend or reach forward, the scar could become visible at the inner aspect of the arm. Importantly, the scars can be devised so that they are not visible from behind, thereby helping to conceal the surgery. I have found that my patients are much less self-conscious when they attend public events, even in sleeveless attire, and there is no incision visible from behind as well as most other angles.
I use a specific protocol for the aftercare of patients in order to speed their recovery and reduce the risk of problems. Depending on a patient’s customary work and the details of their procedure, the recovery may require downtime from several days to two weeks. The specific plan is customized for each patient and the surgery as well as the aftercare will be discussed at the time of consultation.
In this first case, a 33-year-old female is seeking mild improvement in the arms. Figures 1 and 2 show her left arm before surgery, back and front. The skin is not excessively loose, and would be expected to tighten and improve the contour if the underlying fat is reduced.
Figures 3 and 4 show the same arm after liposuction, with improved contour and minimal incisions required. The results are subtler than when skin is removed, but the incisions for liposuction can be barely visible and this particular patient was very pleased that the reduction in fat was able to transform her fuller arm into a slimmer contour.
In the second case, a 51-year-old female is seeking tightening of the loose, excess skin of the arms after successful major weight loss. This is a very common concern of patients who have had bariatric weight loss surgery. Figures 1 and 2 show the left arm before surgery, back and front.
Similarly, Figures 3 and 4 show the right arm before surgery.
After the arm lift, or brachioplasty, the results are shown for the left arm (Figures 5 and 6) and the right arm (Figures 7 and 8). The results are shown at 6 months post-op, and one would expect to see reduced visibility of the incisions after 12 to 18 months.
While these two cases are used to demonstrate a range of procedures to improve the arms, there are other techniques available as well. Of course, results can vary with any procedure, and there is no substitute for a detailed consultation in order to formulate a plan with your surgeon. If you interested in contouring or improvement the arms, feel free to contact me at the office for a consultation.