Definition
An arm lift is a powerful operation that can provide very dramatic improvements in the underarm contour. By removing the excessive skin and fat, a more pleasing and toned arm contour can be achieved. There can be a number of different scar patterns depending on the technique used – this is largely determined by several factors.
Surgical Candidates and Procedures
Patients with primarily fat excess (with little to no skin excess) are candidates for liposuction of the arms. When used as an isolated procedure, liposuction requires that the patient have good quality skin with enough elasticity to retract around the arm after the fat has been removed. Patients with poor quality skin may exhibit a worsened appearance after liposuction, because instead of skin retraction, there is even more sagging of the deflated skin because of the lack of elasticity.
Mild cases of excessive and droopy skin can sometimes be treated with a “minimal incision” brachioplasty. In this scenario, the scar is generally confined to the armpit area alone. The skin quality should be fairly good and liposuction is often combined to reduce the excessive fat that is found in the underarm towards the elbow.
More severe cases of excessive skin require a more extensive excision of excessive skin and fat. A resulting scar extends from the elbow to the armpit along the inner (medial) surface of the arm. This is often combined with the armpit scar creating a reverse “L” or “T” pattern. This allows for the greatest removal of skin and fat redundancy and is the most powerful of the techniques for arm lifting.
Patients who have undergone gastric bypass or lap banding procedures, and have undergone massive weight loss, are generally poor candidates for liposuction of the arms. These patients tend to have low elasticity of their skin and severe sagging of the skin. Dr. Ha recommends excisional techniques in this scenario to provide optimal contour.
The operative time for bilateral brachioplasty is approximately 2 hours. This can be done as an outpatient, but if combined with other procedures, an overnight stay may be recommended. For the most extensive “L” Brachioplasty, drains are placed to help evacuate extra fluid in the arms. These typically remain for 5 to 7 days.
Recovery
Recovery can be from 2 to 6 weeks, depending on the extent of arm lifiting performed. Swelling in the arms, forearms, and hands is very common post-operatively and can last several months before subsiding completely. The majority of the swelling subsides in the first 6 weeks, however. Minor discomfort can be expected for 1 to 2 weeks in the upper arm area, and limited arm activity is recommended during this healing process. A compressive garment is worn for 6 weeks after surgery to help minimize swelling and discomfort.
Scars
The scars can be quite extensive with this procedure and the maturation process can take up to 12 to 18 months. Dr. Ha recommends a scar management protocol post-operatively, which has been quite effective in minimizing their appearance. Most patients will agree that the trade-off of the scar is worth the incredible toned and youthful arm contour that results from an arm lift.