Ask a doctor

Minimal Incision Brachioplasty

I just recently lost about 45 pounds and I noticed that I have minimal sagging and stretch marks on my arms. I inquired to a plastic surgeon about this and she said because it is minimal and I am so young (20 years old), it would not be worth the scar. Is there any solution to my problem that is not as severe? Would any among Mini Brachioplasty, arm toning with exercise, or laser skin tightening be a good option for me? Any advice would help seeing as I am very insecure about this and would like to handle it now while I am young.

Doctor Answers 30

Start with toning your arms through exercise

The arm lift or Brachioplasty leaves a long scar extending from axilla (armpit) to the elbow. As with any cosmetic surgery it is a trade off: is the scar worth the improvement in contour? For women who have lost a lot of weight and have a lot of hanging skin (bat wings) on their arms, the scar is very worth it. For women who have only a little loose skin the scar would not be worth it. At your age, with only a little loose skin, I think with some exercises to tone up the arms ( think Michelle Obama!) you will probably see quite an improvement and enjoy your new contour.

Los Angeles Plastic Surgeon
3.5 out of 5 stars 7 reviews

Sagging arms need arm lift

The best indication for an arm lift, and the most gratifying are those who have lost a lot of weight.  The skin is usually flabby and overstretched.  It is simple and effective to remove the skin that has been stretched past its capacity.  No Liposuction, or other noninvasive modalitiy will help the skin become more firm around the arms.  The length and type of the incision will vary depending upon the location and the amount of fat in the arms.  The cost will also vary by geographic locale.  Most will run anywhere from $3500-$7000.  I would advise you to visit with a board certified plastic surgeon to have treatment recommendations specific to your concerns.

You have options

The key point in the decision is the condition of the skin elasticity. If you have minimal laxity, you may do well with liposuction, or perhaps ultrasound assisted liposuction. This will get rid of excess fat, while encouraging the skin envelope to shrink to the smaller form.

A mini-brachioplasty, as I define it is one that places theincision in the axilla (arm pit) at a right angle to the long axis of the arm. A full brachioplasty extends the incision down the upper arm toward the elbow. I usually do lipo in both instances.

The mini will only tighten skin/tissue from elbow to axilla, while not addressing the skin that hangs down.

You have choices, but you must be evaluated, and surgical planning must take into account what you wish to accomplish, and what you are willing to put up with. The full brachioplasty leaves a visible scar, but if you are OK with that, you may be happy with the result.

I have enclosed a link to my old web site for you to see what is possible.


Sagging arm skin

Thank you for your question regarding sagging arm skin. It is difficult to answer your question fully and accurately without pictures. If you want a surgical solution, I would suggest a crescent or limited T incision brachioplasty. In either case, a minimal amount of skin and fat are removed. The scar is usually well hidden in the axillae. If you do not want arm surgery, I would suggest exercise. I have not seen conclusive results from the arm laser.

Good luck with your quest for skinnier arms.

If you have any questions, please do not hesitate to contact my office.

Sincerely, Dr. Katzen

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 61 reviews

Mini arm lift

You can definitely consider short scar brachioplasty where the incision is hidden along the arm pit region.  This allows a moderate tightening along the inner aspect of the arm.  If you are looking for something non-surgical, then you can also consider trying Ulthera or Profound.  Profound is a new radiofrequency microneedling device that builds collagen and elastin in the tissues and may help you get the mild/moderate degree of tightening that you are looking for.  Ulthera is ultrasound based and can help firm the region by stimulating collagen.

Treatement option for skin excess

standard, minimal or no scar?

one rule in plastic surgery, more scar is more results.

patient with minimal  scar, should expect lesser result.

thats why we reserve those surgeries to minimal deformities.

no scar, with non invasive procedures are rarely effective or cost effective.

so the short scar surgery can be a good compromise

Jacques Haddad, MD
Montreal Plastic Surgeon
5.0 out of 5 stars 5 reviews

Mini Brachioplasty

If you have minimal skin laxity and excess fat you may be an excellent candidate for SAFE Liposuction with or without a mini brachioplasty which is a small scar located in the axilla which excises the majority of the sweat glands, as well. In my patients, it has been very effective in reducing fat and simultaneously reshaping the arm to a smooth cylindrical shape which most women desire.  We usually treat the scar postoperatively with a combination of silicone gel treatments with erbium laser resurfacing and obtain excellent results with this combination. 

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
5.0 out of 5 stars 43 reviews

Minimal incision brachioplasty, option?

Since you are young and did not have a massive weight loss, you probably have good skin elasticity.  A limited incision (mini brachioplasty) may just be ideal for you.  I would recommend toning your arms first and then decide if you still want surgery.  Often a toned arm is attractive and you will not feel insecure about any loose skin.  If not, then you should discuss the mini brachioplasty with your plastic surgeon

John Zavell, MD, FACS
Toledo Plastic Surgeon
5.0 out of 5 stars 18 reviews

Brachioplasty scar can be hidden in the armpit

Because you are young and had some weight loss, it might be possible for you to have the skin removed in the armpit. This works to tighten the upper arm only, though, so if you have loose skin that extends down towards your elbow, you probably will need the full lift.

Anne Taylor, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 27 reviews

Surgical Options Best For You

                  It’s not unusual for patients to develop excess arm skin after significant weight loss. When this occurs it can represent a significant aesthetic deformity that’s not easily hidden. In most cases treatment involves removal of excess skin but treatment is frequently associated with noticeable scarring of the arms. Patients are often motivated to avoid this scarring by utilizing less aggressive procedures.

                  Without being able to perform a physical examination, it’s virtually impossible to make a specific treatment recommendation. Unfortunately, after a 45 pound weight loss, a more aggressive procedure is probably indicated. Several surgical options exist for treating this condition, including liposuction, mini brachioplasty and full brachioplasty. The procedure chosen is dependent on the patient’s aesthetic goals and their specific anatomic findings.

                  In some cases, liposuction may be a viable alternative. When this procedure is utilized, scarring is minimal and results are usually excellent. Unfortunately, this procedure is only effective when fat is present and the skin is relatively tight.

                  When excess skin is confined to the upper arm in the area of the axilla, a mini-brachioplasty may be effective. This procedure utilizes an incision in the upper arm which is transversely oriented and well hidden. The procedure is helpful when patients have minimal excess upper arm skin and is associated with excellent results.

                  Unfortunately, the vast majority of patients who have had significant weight loss require more extensive procedures. In most cases, this involves a full brachioplasty with an incision that extends from elbow to axilla. This procedure addresses excess skin in the vertical and transverse dimensions. In most cases, results are excellent, but occasionally adverse scarring can be a problem.

                  When significant excess skin is present, laser tightening and other non-surgical treatments aren’t effective. For this reason, patients who have significant arm skin sag should consult a board certified plastic surgeon who can formulate an appropriate treatment plan. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.