Drooping or sagging upper arms are commonly seen in the following conditions:
- Significant weight loss
- After bariatric surgery
Regular exercise may strengthen and improve the underlying muscle tone of the upper arm, but it cannot address excess skin that has lost elasticity or underlying weakened tissues and localised fat deposits. If the underside of the upper arm appears loose or sagging and full due to excess skin and fat, an arm lift is a choice of treatment.
Arm lift (brachioplasty) is a cosmetic surgical procedure to remove excess skin and underlying fat that occurs between the underarm and the elbow. This surgery will also reduce the circumference of the upper arms resulting in smoother, tightened skin, a more toned and proportionate appearance.
Approach to arm lift begins with an incision on the inside of the arm or the back of the arm. The length and pattern of incision made may vary depending upon the amount and location of excess skin and fat to be removed. Depending upon the length and location of incision made for an arm lift, this surgery can be divided into:
- Invisible arm lift: excess skin and fat are removed at the armpit resulting in a short scar within the armpit crease.
- Traditional arm lift: the incision is placed on the inside of the arm or the back of the arm and extends to just above the elbow.
- Extended arm lift or chest (thoracic) lift: the incision is like the traditional arm lift except that it is extended from the arm down the side of the chest.
During arm lift surgery, the underlying supportive tissue of the arm is tightened and reshaped with internal sutures. Hence, the final result achieved will be a smoother and well-contoured arm. Occasionally, in some instances, when excess fat is present and needed to be removed, arm lift surgery may be combined with liposuction.
Other alternatives to arm lift surgery for individuals without excess skin will be:
- Radiofrequency therapy
Ideal candidates for arm lift
- Adults with significant upper arm skin laxity
- Adults of any age whose weight is relatively stable and who are not significantly overweight
- Healthy individuals who do not have medical conditions that can impair healing or increase the risk of surgery
- Individuals with a positive outlook and realistic expectations
Preoperative evaluation for arm lift
Communication is vital to achieving the patient’s goals. During the initial consultation, patients will have the opportunity to discuss their goals and desired results with the plastic surgeon. The plastic surgeon will work closely with the patients to reach an agreement about the expectations from the surgical procedures involved and their long term benefits. Every patient is different. Therefore a specific treatment regimen is planned to suits an individual’s need. The preoperative evaluation for arm lift includes:
- Discussion about patients’ expectations and desired outcome
- Medical conditions, drug allergies and previous medical or surgical treatment
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Discussion of type of anaesthesia
- Physical examination
- Photography for preoperative and postoperative evaluation
Preparation for arm lift
- Get laboratory testing or a medical evaluation
- Adjust your medications if you have certain medical conditions
- Stop smoking and alcohol well in advance before the scheduled date for surgery
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements before surgery
- Special instructions will be given on the day before and after surgery
The risks and safety information on arm lift
It is vital for patients to understand that every surgical procedure has its complications and downtime. However, if a patient is assessed correctly before the surgery and postoperative care is given adequately, these risks can be eliminated or reduced.
Some of the common risks of arm lift:
- Poor wound healing
- Wound breakdown
- Skin discolouration
- Swelling due to a blood clot or fluid accumulation
- Fluid accumulation
- Scarring (hypertrophy or keloidal scar)
- Temporary numbness or changes in the skin sensation
- Possibility of revision surgery
- Anaesthesia risks
After the surgery, temporary dressings or bandages are applied to the incision sites. Small tubes may be temporarily placed under the skin to remove any excess blood or fluid that may be collected after the surgery. Once the tubes and temporary dressings are removed, the patient is advised to wear a compression garment (for 4-6 weeks) to minimise the swelling and support the arms during the healing phase. There may be swelling, bruises, discomfort or tightness at the arms and underarms for several days that can be controlled with oral medications. Regular cold compression to the operated sites may reduce the postoperative swelling. Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain, respectively. Stitches will be removed on 7-14 days after the surgery. The final result of surgery will appear within several weeks or months, but it may take up to a year for incision lines to fully refine.
Case No 1:
Case No 2:
- Regular application of antibiotic ointment and cleaning the operated areas for the first one week after the surgery
- Bed rest with your arms elevated to reduce swelling
- Avoid excessive arm movement or weight lifting for the first 10-14 days after surgery
- Arm movement should be limited for up to 4 weeks following the surgery
- Resume regular activities between 4 and 6 weeks after an arm lift
- Wear compression garments for 4-6 weeks after the surgery
- Proper use of scar gel and sunblock 2-3 weeks after surgery to improve the scar appearance
How much will an arm lift surgery cost?
Cost is always a consideration in elective surgery. The cost of an arm lift can vary widely.
The cost of arm lift may include:
- Surgeon’s fee
- Hospital or surgical facility costs
- Anaesthesia fees
- Compression garment
- Prescriptions for medication, and
- Medical tests
An arm lift is a cosmetic surgical procedure, and most of the health insurance does not cover cosmetic surgery or its complications.