For many patients, the upper arm is a focal region of concern as redundant skin and soft tissue develops. This commonly occurs following weight loss and the natural aging process. Patients considering arm lift surgery often report feeling uncomfortable when wearing short sleeve shirts and dislike this drooping tissue. Following massive weight loss, patients often express that they are not able to fully enjoy their new figure given this skin redundancy.
Both massive weight loss and the natural aging process result in loss of skin elasticity. Many patients develop skin excess and descent of soft tissues of the upper arms. It may be frustrating that no matter how much training is performed, this skin redundancy is often unresponsive to exercise.
What is Arm Lift Surgery?
Arm lift (brachioplasty) is a surgical procedure that removes excess skin – and subcutaneous tissue to a lesser degree – of the arms. It may be performed to tighten the skin and soft tissue envelope of the upper arms. This skin has been stretched beyond its ability to retract. Patients often dislike the appearance and sensation of this jiggling tissue.
An arm lift is the only way to remove the redundant skin and to tighten the skin envelope given increased skin laxity. It is performed under general anesthetic in an operating room setting. The incisions for arm lift surgery vary based on the patient’s aesthetic goals and clinical presentation. Incision and resultant scar placement will vary depending on the degree of redundant tissue. Arm lift may range from a limited incision within the underarm region, to an incision extending down the medial (inner) arm to just above the elbow. In more severe cases, the incision may extend onto the side of the chest wall to tighten skin and resuspend soft tissues in this region.
Although a small scar may be placed within the underarm to correct mild skin redundancy, more commonly an incision is made from underarm to elbow level. This is the trade-off in arm lift surgery to improve arm contour. The traditional arm lift may achieve more dramatic results at the expense of a longer scar. This scar may widen with time, but will generally fade to appear skin-colored. It is important for patients to consider the scar appearance when wearing short-sleeve clothing.
Who is a candidate for an arm lift?
The most appropriate candidate for arm lift surgery has redundant skin of the upper arm and is willing to tolerate a scar to improve arm contour. It is not possible to remove redundant skin and to tighten the soft tissue envelope without leaving a scar, which extends from the underarm to elbow region in most cases. Most patients presenting for arm lift surgery understand this trade-off and are willing to accept a scar to remove this redundant tissue. The most appropriate candidate for arm lift wishes to removes the drooping tissue of the upper arm, which often jiggles with upper body activities. Candidates for arm lift are willing to accept the scar for the end outcome. The scar may be concealed for important events using scar-concealing make up if desired.
It is also important for patients undergoing arm lift surgery to be otherwise healthy and non-smokers. Smoking increases the risk of wound healing complications, including wound dehiscence (referring to wound separation), infection, and skin flap necrosis. Smoking cessation for at least one month pre- and post-operatively has been shown to lower the risk of developing wound healing complications.
Patients considering arm lift should also achieve and maintain a healthy body mass index, ideally less than 25, before undergoing surgery. Arm lift is not an appropriate surgery for reducing fatty tissue to reduce the overall size of the arm. The most appropriate candidate presents with redundant skin as opposed to fatty tissue excess. A small focal region of adiposity may be removed through arm lift, however it is not an effective surgery for weight reduction.
What are procedure options for arm lift surgery?
The two main types of arm lift surgery are the mini and traditional arm lifts. In a mini arm lift, a small portion of skin may be removed through a limited incision in the underarm. Liposuction may also be performed during this procedure for further sculpting of the arm. This procedure is appropriate for those with minimal skin and fatty tissue excess. Most patients considering arm lift do so for drooping tissue of the upper arm. These patients generally require a traditional arm lift, which leaves a longer incision from the underarm to elbow level. Lesser invasive options will not achieve equivalent results to a traditional arm lift.
What are risks and benefits of arm lift?
The main benefit of brachioplasty is the improvement of arm contour and tightening of the soft tissue envelope through resection of redundant skin. It is not an effective technique to reduce fatty tissue of the arms. The trade-off for a traditional arm lift is a long scar. Other risks of surgery include bleeding, hematoma, impaired wound healing, infection, fluid accumulation (seroma), overresection potentially requiring delayed closure or a skin graft, risk of injury to surrounding structures, and numbness. There are also aesthetic complications including asymmetry, over- or undercorrection, hypertrophic scarring, and dissatisfaction with aesthetic result. Arm lift is generally a well-tolerated procedure in appropriately selected patients who understand the scar placement and are well-educated about the procedure.
Arm Lift FAQ
How painful is an arm lift?
Patients will initially experience tightness and localized discomfort over the first few days following arm lift surgery as swelling peaks. Pain medication is generally required during this time period. Cold compresses and limiting upper body activities are also effective in reducing discomfort during early recovery. After a few days most patients are able to wean from prescription pain medication and to take only Tylenol plain or extra-strength as needed.
What is anticipated recovery after arm lift?
Most patients are able to return to office-based work within a week of surgery. If job responsibilities are more strenuous, a longer recovery period may be required. It is important to discuss your job requirements with Dr. Power pre-operatively, who will then be able to make specific recommendations. Exercise and strenuous lifting should be avoided for one month following arm lift surgery to lower risk of healing complications, particularly bleeding and increased swelling which would increase risk of wound healing complications.
Is arm lift an effective technique for addressing fatty tissue?
Unfortunately not. A focal fatty deposit may be removed during arm lift with the resection of redundant skin. It is not an effective surgery for weight reduction or for reducing overall size of the arm.
What occurs during consultation for arm lift?
During your initial consultation, a detailed medical history will be performed to understand any medical conditions, medications, or other factors that may influence surgery or recovery. It may be required to see another medical practitioner or specialist pre-operatively to ensure that other conditions are optimized before undergoing elective cosmetic surgery. Dr. Power will listen carefully to understand your aesthetic concerns and goals of surgery. Physical examination will be performed to assess the degree of skin laxity and redundant tissue of the arm. Pre-operative photographs will also be taken and basic work up ordered prior to surgery, including labs and potentially other investigations based on your overall clinical picture. The surgery will be discussed in detail to ensure that you understand the procedure as well as all associated risks. If interested in proceeding, Dr. Power requires a second visit before booking surgery to review the operative details, to complete the required paperwork, and to answer any remaining questions.
How should I prepare for arm lift surgery?
It is important to stop taking anti-inflammatories during the month leading up to surgery to reduce risk of bleeding. Tylenol plain or extra-strength may be taken during this time period if needed for any discomfort. Dr. Power will make specific recommendations based on your particular medications and herbal supplements. She will also advise which medications to take on the morning of surgery with a sip of water while fasting. It will be helpful to stock up on groceries and other basic household items before surgery to ensure that you do not have to run any errands during early healing. Please arrange to have a companion pick you up following arm lift surgery and to stay with you for 24 hours after the general anesthetic. Your prescription for post-operative pain medication should be filled in advance. Many patients also find it helpful to prepare ice packs in advance. Specific instructions regarding the time to arrive at the Surgical Suites at 199 Avenue Road will be confirmed a few days before surgery. Please begin fasting (no eating or drinking) at midnight before surgery.
Brachioplasty is performed as outpatient surgery under general anesthetic. Patients are required to wear a compression garment post-operatively, which may be concealed under long-sleeve clothing. This may serve to decrease swelling and to expedite healing. Patients may generally return to work within 1-2 weeks, however must refrain from strenuous activity or heavy lifting for 4-6 weeks post-operatively.
Please contact us to schedule your consultation.