A common procedure for people who have experienced weight loss, the arm lift or brachioplasty is a surgical procedure that reshapes and provides an improved contour to the upper arms and connecting area of the chest wall. The underside of the upper arm is reshaped from the armpit to the elbow, loose skin is tightened and excess fat removed, thus removing the “bat wing” appearance. Fluctuations in weight, growing older and heredity are some of the factors that cause arms to have a drooping, sagging appearance, which cannot be corrected through exercise.
Arm Lift Techniques
Dictated by the patient’s skin quality and the extent of the excess underarm fat, surgical options will be discussed with your surgeon, who will help you make the right choice. Liposuction is often used during an arm lift and may also be used as an adjunct for fat removal in a standard brachioplasty. It is a procedure recommended for people whose skin has enough elasticity to shrink around the remaining tissues after the fat is removed. Tissue sagging will be more pronounced after fat is removed if the skin has poor elasticity.
The limited-incision brachioplasty is recommended for patients with loose, crepe-like skin in the lower arm area near the armpit and who do not have too much excess fatty tissue. If excess hanging skin is located close to the armpit, the surgeon may be able to pull up and tuck the excess skin into the armpit.
In the case of standard brachioplasty, the only option is complete removal of the arm flab if the excess skin extends like a bat wing from the armpit to the elbow. The extended brachioplasty is similar to the standard one, except that the incision is extended along the arm down to the body to include loose skin and fatty tissue that may be hiding under the arm area along the side of the chest wall.
Arm Lift Surgery Steps
Arm lifts are usually performed under general anesthesia and may take up to 3 hours. You should expect the following:
- the surgeon will create markings on your elbows, arms and armpits, dictated by the type of brachioplasty you will undergo
- you will be anesthetized (either IV or general, based on your surgeon’s recommendation)
- incisions will be made completely concealed within the armpits or extended down the inside of the arms, in order to remove excess skin and fatty tissue
- liposuction may be used as an adjunct to remove excess fat
- the incisions will be brought together to provide a firmer and smoother arm contour
- the skin is smoothed over the new contour of the arm
- incisions are closed and sutures may be placed beneath the skin, where they will gradually be absorbed by the body
- drains may be placed and a sterile dressing and a compression garment will be applied
Risks and Safety
Before the surgery, your doctor will ask you to sign consent forms to ensure that you fully understand the procedure. Significant complications from upper arm lift surgery are infrequent and the procedure is usually performed without any major problems. All surgical procedures have some degree of risk and the common potential complications include:
- anesthesia risks
- bleeding
- infection
- poor wound healing
- unsightly scarring
- fluid accumulation
- hematoma
- changes in sensation
- damage to underlying structures
- allergic reactions
- unsatisfactory results that may necessitate additional procedures
These risks will be fully discussed prior to your consent. You can also help minimize certain risks by following the instructions and advice your surgeon provides you with, before and after the arm lift surgery.
Preparing for Consultation and Surgery
Your surgeon will provide detailed preoperative instructions, answer any questions you may have and determine your fitness for surgery after taking a detailed medical history and performing a physical exam. During your arm lift surgery consultation be prepared to discuss:
- current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
- medical conditions, drug allergies and medical treatments
- previous surgeries
- your surgical goals
Before your procedure, the surgeon will ask you in advance to:
- stop smoking to promote better healing
- avoid taking herbal medications, aspirin and certain anti-inflammatory drugs
- keep yourself hydrated before and after surgery
- get a lab testing or a medical evaluation
Be sure to arrange for someone to drive you home after surgery and stay with you for at least the first night following surgery. Wear comfortable, loose clothing during the day of the surgery. For your safety during the operation, you will receive medications to keep you comfortable and various monitors will check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood. You will be taken into a recovery area where you will continue to be closely monitored after the procedure is completed.
Am I a Candidate for an Arm Lift?
If you are in good general heath, have a positive attitude and realistic expectations, you are more likely a good candidate for this procedure. After losing a significant amount of weight and embarking on a program of vigorous exercise, you may find that you will have loose, hanging underarm skin that resembles bat wings. Although you can improve upper arm appearance with exercise, the underarm skin remains a problem that does not improve with exercise. Arm lift candidates include people who:
- are adults with significant upper arm skin laxity die to aging
- are committed to a healthy diet and lifestyle
- are healthy individuals with no medical conditions that could impair healing or increase surgery risks
- are non-smokers
- have a relatively stable weight and are not significantly overweight
- have lost the weight they desire, but are left with redundant underarm skin
Scarring will be permanent, but should fade in time as improvements to scars may take around a year. You must also expect a degree of sagging in the future as you age. Brachioplasty will not stop your upper arms from sagging if you gain and lose a large amount of weight in the future.