- Asked by Kathy the Trainer
- 10 months ago
I'm having brachioplasty surgery. I have received conflicting opinions on Different techniques. Is it best for the incision to be in the brachial groove or in the back of the arm? And why?
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Brachial Groove Incision Most Hidden
Thank you for your question. There are advocates for both incisions. The benefits of the brachial incision is that with time it heals well and is hidded from all views when the arms are down. It is only visible when the arm is raised. The posterior incision looks good on postop photos as the incision does not show, but when your arms are at your side and you are wearing a short sleeve, the incision is visible from the back. This can be embarassing when questions are asked at the supermarket. In skilled hands, you can achieve an excellent result with either technique, but patients are better served long term with a medial rather than posterior incision.
Brachiplasty Incision Placement Experiment
There are two schools of thought regarding brachiplasty incision placement, the brachial groove or the posterior arm camp. Both can yield good contour correction. If you look at postop photos from the posterior arm camp, the contour of the arm is nicely corrected, but there are no scars visible in the standard views. Unfortunately, in social settings such as a supermarket line, the posterior scars are very visible and attract a lot of attention. In contrast the medial brachial groove incision is only visible when the patient is waving or arms are up in postop photos. Most people keep their arms at the side most days. In this position the scars are not visible from the back, sides or front. Over time the medial scar fades well and most patients begin wearing short sleeve or sleevless clothing...this would be hard with a posterior scar. To answer this question definatively for your self, take a sharpie and put a thick black line on the inside of one arm and the back of the other arm. Wear it for a week in public and see which one attracts the most attention. That should help you answer your question in an unbiased way. Hope that helps.
Incision Placement Choices for Arm Lift Surgery
The best position in my opinion for a traditional brachioplasty, arm lift, is when they are hidden with you arms at your side.Incisions are placed in a inside location on the underside of the arms (the part of the arm that is against the body with the arms hanging at their side), between the armpit and the elbow. The length and location of the scar is dependent on the location of the unwanted and excess soft tissue. The unwanted skin is removed to reveal the arm’s natural shape. In many cases, liposuction is used to remove excess fat to enhance the natural contour of the arm. If there is limited fat and loose skin close to the arm pit then a short scar technique leaving the final scar in the arm pit, axillary, crease may be possible
Incision location for brachioplasty
The best incision line is the one the patient chooses. There are no right answers, but arms with less skin excess can get by with shorter scars. In many cases I try to limit the scar to the armpit with no extension down the arm. Make sure you consult a Board Certified Plastic surgeon and be sure to see a comprehensive portfolio of pre- and post-op pictures so you can see what results are typical.
Arm Lifting Scar Concerns?
Thank you for the question.
There is not necessarily a right or wrong answer here. My preference, having done the operation using both “techniques”, is to plan the excision such that the resulting scar falls along the most inferior aspect of the arm; the goal is to make it so that the resulting scar is not visible from the front or back. In comparison, I find that the scar in the bicipital groove will be visible from the front.
Unfortunately, regardless of where the scar ends up, arm lifting scars can spread, requiring revisionary surgery to improve the results.
I hope this helps.
I like the brachial groove scar, because I think the scar is less noticeable there.
There is not a "better" choice, just whichever your surgeon prefers.
In an extended brachioplasty, I can put the scar anywhere the patient desires. It is my belief that the incision in the bicipital groove is the most appropriate in most patients as most people during casual observation do not expose the medial aspect of their arms. The posterior scar is more visible in walking in short sleeve shirts. With regard to nerve injury or vascular injury, I have never seen one, but this is more the result of the dissection and not the placement of the scar. Kenneth Hughes, MD Los Angeles, CA
Arm Lift Scar Placement
One of the most important considerations before an arm lift is the tradeoff of better shape and contour for the chance of noticeable scars. While there is no "correct" answer to your question, I have found that scars placed on the back of the arm are preferable for two reasons. First, they cannot be seen when someone is standing in front of you, which I believe makes them less conspicuous overall. Secondly, the posterior scar approach allows for contouring of the area where the upper arm meets the side of the chest, and this can be important to patients with a lot of loose skin. With that that said, you can get great results with either technique, and the most important consideration is to have a board certified plastic surgeon evaluate and treat you. Good luck!
I always tell weight loss patients who are undergoing brachioplasty that there is a trade off for loose skin in the arms versus the scar ... So if you don't want to see the scar from behind with arms at your sides, then we place it in the biceps area..
do offer options as before, everyone kept the incision and resultant scar in the brachial groove to hide the scar when your arm was next to your body. The scar was never a great scar and resulted in the development of different techniques. The scar at the bottom of the arm is visible when your arm is at your side and that is what this is mostly about - visibility of scars.
I was fortunate enough to have a patient willing to have it one way on one side and the other way on the other side. Hands down, she liked the scar at the bottom much better and now I do my brachioplasties that way and have not had any complaints about the scar. Its an easier procedure that can be revised more easily as well. You should pick what will work best for you and your needs.
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.