There has been an increasing interest in arm lift surgery (or brachioplasty) nationwide. Patients who undergo massive weight loss (either through lifestyle changes or bariatric surgery) typically will have excess skin. Typically this skin is very thin and no longer elastic; the only effective way to get rid of this type of skin is to reduce it. Patients who seek arm lift surgery want to be able to wear sleeveless shirts in the summer or find sleeves that fit them better.*
*Individual results may vary.
When considering arm lift surgery, it is extremely important to understand that this surgery is always a tradeoff. Reduction of excess loose skin requires long incisions (or permanent scars) to do so. To obtain the most drastic results, a scar is typically placed in the inside of your arm and runs from the axilla (armpit) to the elbow. This scar is lengthy and visible, but may fades and lighten in color over the first year. If a patient has large amounts of excess skin that look like “bat wings,” then this may be an option to consider. However, if a patient has just a little bit of extra skin and fat they want removed, this is likely not a good option as it may not be worth the appearance of the scars.
Is liposuction an option?
The arms is usually not an ideal area for liposuction. Liposuction reduces excess fat, but relies on good quality skin to contract to the new thinner contour underneath. The skin on the arms typically is thin and not elastic, especially in massive weight loss patients. In such patients, liposuction would only create even more loose skin, which is not attractive.
What makes a good candidate for arm lift surgery?
The ideal candidate for arm lift surgery is one who is in good overall health and in good shape. You should have a body mass index (BMI) of 30 or less. Higher BMIs are associated with more issues with healing, results, and surgical safety. If you are still planning on losing a significant amount of weight, do that first, be stable at your goal weight, and then plan your arm lift surgery after to optimize your results.
Arm lift surgery is done on an outpatient basis where you will get to go home the same day. It is performed under general anesthesia where an anesthesiologist monitors your closely and safely. The actual surgery portion will usually be approximately 3 to 4 hours long, depending on how much excess tissue you have. You will be placed in dressings and sometimes, compressive garments to help minimize the postoperative swelling. You may have a drain in each arm, which will be removed at a future clinic visit. You are then taken to the recovery room where a nurse monitors you and once you have recovered from anesthesia (usually after an hour), you will get to go home with your family that same day. It is important that you have a driver (not a taxi, Uber, or yourself!). It can be dangerous to drive immediately after having general anesthesia.
For the first few days, your arms will be sore. Elevating them on some pillows to allow gravity to help keep the swelling down will help with soreness. You can usually shower and then replace your garment and dressings. These garments are specially ordered for you and typically kept on for 4 to 6 weeks while you heal.
Returning to work
Dr. Wong will see you within a week of your surgery to check your surgical sites and possibly remove your drains if you have any. Depending on what type of occupation you have, most patients take 1 week off from work if they have a low impact desk job. For patients who have more strenuous, labor-intensive jobs, they should ask for light duty or be excused from work for the full 4-6 weeks. You do not want to do any heavy lifting or extreme exercising during this recovery period. This does not mean you should be lying in bed all the time or under house arrest though; walking is encouraged!