Treatment In Focus: Brachioplasty

Often excess skin or fat can be a problem for patients in the upper arms. It can lead to patients limiting the clothes they wear ; women especially find the aging changes related to the upper arm disturbing. The most common complaint is not feeling comfortable wearing short sleeves or not liking the appearance of the arm/chest junction in a bra. Providing an improved contour in the upper arms can rejuvenate the upper arm and provide an improvement to a patient’s quality of life.

This excess fat and/or skin in the upper arms can lead to poor definition of the arm/chest junction. Excess tissue at this junction can also lead to a discomfort in bras and can be both uncomfortable and unsightly. For patients with excessive weight loss arm lifting can be combined with other procedures in other areas of the body.

The location of excess fat and skin and the quality of skin of the arms and chest wall often determine what are the best options are for patients. Liposuction on its own can reduce the volume of fat and where skin tightening is performed simultaneously improvements may be gained. Usually in the upper arms excess skin is present and surgical excision in combination with liposuction is often the only reliable way to improve contour.

Where only skin excess is apparent surgical removal offers a permanent solution.
With surgical removal scars need to be placed in the armpit.There may be only a short scar limited within the armpit – short scar armlift. Often the scar needs to be extended but this can be limited to avoid extending thescar towards the elbow – armlift with limited incision. For excess fat and skin one often needs to extend the scar down the arm and/or down the chest – armlift with extended scar. It is important to place these scars in such a way that it is difficult to visualise these.

Short scar arm lifting with placement of scars in the armpit gives limited results and does not address excess tissue on the chest or the majority of the skin of the upper arm.There are also occasions where patients are not happy with a bulge in the upper part of the chest near the armpit.Where this is not related to issues of skin and fat excess in the upper arm a short scar arm lift can help to improve this contour by a short scar approach.

For the majority, armlifting requires a scar that extends down the arm.This can be limited or can be extended down to the elbow, into the armpit and down the side of the chest.This scar often heals extremely well although it can take a number of months / years for the scar to fade into a white line.The scars can often be initially tight and it is important for patients to mobilise immediately to prevent any form of contracture. In the armpit and the upper part of the arm there is a tendency for the scars to stretch. For patients these scars are very well tolerated and it is extremely uncommon for patients to complain about these scars long term.

It is rare for skin excess to be present in the forearm and one must weigh up the pros and cons of removing any excess tissue below the elbow that would require a scar that crosses the elbow. Scars that cross joints can cause contracture and may result in limited mobility.

Arm lifting can be performed alongside other body rejuvenation procedures and it is important to discuss these options with someone with experience in all body contouring procedures. It is recommended that all surgical times should be less than 4 hours to limit anaesthetic issues. For the majority of arm lifts the procedure is carried out under general anaesthetic. Although there is swelling and some discomfort arm lifting is relatively not a painful procedure. Patients may be able to go home the same day and currently I do not use any drains and use minimal dressings.The reduction in drains and dressings allows patients to mobilise immediately.The recovery following arm lifting is relatively quick. It is uncommon to develop excess swelling (seroma) and although there may be small areas of the scar that take some time to heal the wound complications are usually minimal.

Download Article