Introduction: What is Brachioplasty?
Brachioplasty, also known as an arm lift, is a procedure that removes excess fat and skin from the upper arm above the level of the elbow. It helps in toning your arms and providing an appealing contour to them. Advancing age, weight fluctuations, and genetic factors result in sagging and drooping of the upper arms that can hamper your appearance.
Exercise can only strengthen the underlying muscles of the upper arm, it does not improve the skin laxity or manage the fat deposits underlying weakened tissues. However, Brachioplasty can successfully deal with all these problems and the results of the surgery are long-lasting.
Who is an Ideal Candidate for a Brachioplasty?
Arm lift surgery candidates are those patients that have significant excess sagging skin with poor elasitcity of the upper arm. If patients also have excess fatty deposits of the upper arm they may need liposuction in addition to skin excision for best results.
- Patient should be at their goal weight and be relatively stable at that weight
- Healthy individuals without significant medical comorbidities
- Non-smokers
- Patients with realistic expectations of what an arm lift can achieve for them
Preoperative Assessment
Before your procedure, a detailed medical history is obtained, and a thorough physical examination is performed. During your consultation, your doctor will advise you to stop smoking, if you smoke, to avoid post-surgical complications and delayed healing. You should eat a healthy diet and avoid any restrictive dieting during this time. You should inform your doctor of all medications that you are taking and about significant medical conditions, allergies and previous surgeries if any.
Photographs will also be taken during pre-operative consultation to submit for insurance, to be used in surgical planning, and for before and after comparison. Your goals will be discussed, and realistic expectations will be set. After discussing surgical options, we will make an individualized surgical plan together that best suits your goals.
This is the best time to ask all your questions so that you can feel comfortable and confident going into surgery.
Procedure: Brachioplasty
The common steps involved in brachioplasty are as follows:
- The procedure is performed under general anesthesia.
- An incision is made over the skin, the length and pattern of which depends upon the location and amount of excess skin to be removed as well as the judgment of the plastic surgeon.
- In general, incisions are placed on the inner side of the arm and extend from the underarm (axilla) to the elbow. Occasionally the incision may extend along the lateral chest wall and possibly incorporate into a breast lift incision.
- During the procedure, the excessive fat may be removed through liposuction.
- Internal sutures help in forming new contours by tightening the underlying supportive tissues.
- For the most part your incisions will be closed with dissolvable sutures that will be under the skin and you will have either surgical glue or surgical tape over your incisions which take about 1-2 weeks to fall off.
- You will have drains in place after surgery that will be removed in 1-2 weeks.
Risks and Complications of Brachioplasty
The possible risks and complications associated with brachioplasty include:
- Inauspicious scarring
- Anesthesia risks
- Bleeding
- Blood clots in the lungs or legs, cardiac and pulmonary complications
- Delayed healing
- Fluid collections (seroma)
- Continued swelling of the arms
- Fat necrosis
- Numbness or changes in skin sensation
- Asymmetries or suboptimal aesthetic results
- Recurrence of loose skin
- Scarring
- Infection
- Possibility of revision surgery
Recovery after Brachioplasty Procedure
After brachioplasty there will be some temporary pain, discomfort, and swelling. Medications will be prescribed to relieve pain. You will wear a contoured elastic garment for extra support around the chest and upper extremities . Most patients can undergo brachioplasty as an outpatient procedure. Some patients may stay overnight for observation which will be discussed in your pre-operative appointment. Upon discharge, patients will be instructed about proper wound care and how to manage their drains at home. Stitches are usually dissolvable and internal. Specific post-operative care regimen to minimize scarring will be discussed with each patient. Strenuous physical activity and heavy lifting over five pounds is discouraged for six weeks post-operatively – details of this limitation will be discussed with you specific to the surgery that you will be having. Patients should also avoid any excessive force or motion during the healing process of the surgical incisions. You will likely be able to resume work in 2 to 3 weeks depending on what kind of job you have and how you are feeling. Full recovery may take up to one year and you need to have follow-up appointments to ensure a positive surgical outcome.
Summary
Brachioplasty or arm lift is a procedure that trades scar for improved contour of the arms, so that loose skin does not hang down. The results of a brachioplasty are evident almost immediately; however, it may take some time to see the full results while swelling, bruising and scarring improve.
