Arm lift: Drains or no drains? Lipo or no lipo? I have consulted 2 doctors and am confused as their approach is very different

Question

I have genetic hanging arms with a medium amount of fat I have been to 2 plastic surgeons No1 was happy to do an armlift in day surgery with no lipo and no drains No.2 wants me to be in hospital for 4 days with 2 drains and lipo I am very confused the first doctor does this operation once a month and the second one does a couple a month. I am very confused how can they be so different The first doctor made me feel very confident but the second made me feel scared What do you think?

J. Timothy Katzen, MD, FACS · Answer

I perform a significant number of arm lifts weekly. I believe arm liposuction is an extremely important to a successful arm lift or brachioplasty.  About 10 years ago, during the arm lift procedure, I was not performing arm liposuction. Presently, I perform arm liposuction on all arm lift or brachioplasty procedures. Arm liposuction does three main things. One, it removes fat. The benefits of this procedure should be obvious. Two, arm liposuction aids in dissection during the arm lift procedure. Liposuction helps to define an important nerve in the upper arm. If this nerve is cut, it can lead to permanent forearm numbness. Liposuction helps to identify this nerve during surgical dissection and prevent nerve damage.  Thirdly, I believe arm liposuction leads to a better surgical closure. Arm fat removal reduces tension and leads to a better recovery. I believe arm liposuction reduces the chances of wound breakdown and significant scarring.  In the past 14 years, I have never used arm drains.  I believe if the arm lift or brachioplasty is done correctly, drains are unnecessary.

Kenneth Hughes, MD · Answer

I have done many arm lifts and many arm lifts in combination with other procedures.  I have performed all of these as outpatient surgeries.  I would look at reviews and before and after pictures.Kenneth Hughes, MDLos Angeles, CA

Tom J. Pousti, MD · Answer

Receiving different opinions from different plastic surgeons is quite common.  Ultimately, you will need to be comfortable that your plastic surgeon has the experience to achieve the outcomes you are looking for in a predictable and safe fashion. Ask to see lots of examples of his/her work achieving the outcomes you would be pleased with.   In my practice, I perform the arm lifting procedure as an outpatient, use liposuction as a tool as necessary, and do not find the use of drains necessary. You may find the attached link,   addressing arm lifting concerns, helpful to you as you learn more.  Best wishes.

John Zavell, MD, FACS · Answer

The surgical approach to arm lift surgery, also known as brachioplasty, will depend upon how much laxity there is in your arm.  If your arm is thick but with little hanging tissue, then liposuction is a good choice.  If your arms have mostly hanging, loose skin, then excision ( arm lift) is best.  Sometimes for people with thick arms and loose skin, liposuction and excision are best.  I generally do not use drains and I perform this surgery in an outpatient setting

E. Anthony Musarra II, MD (in memoriam) · Answer

Dear JDAnon,The only thing that is going to make you happy is combo brachiaplasty and liposuction.Liposuction alone is wasting your money.  Brachiaplasty will give you a very good result.If done with brachiaplasty and liposuction, I think you will get the best result but more expensive, more swelling and best to use drains.  No need to go to hospital.  This isoutpatient procedure.Dr. Anthony MusarraMarietta/Atlanta, Ga.

Joshua Korman, MD - Account Suspended · Answer

Removing extra skin and fat in the arms has produced several different techniques among plastic surgeons as there is not necessarily one correct answer. For this reason it is not unusual to get different opinions from different practioners.  I used to use drains, but don't anymore. I almost always do liposuction in conjunction with brachioplasty (arm lift) even if there is not much fat to remove. This is not to remove the fat but to help the skin to contract as much as possible after the procedure. I use a combination of VASER and SmartLipo which I find is very helpful in skin contraction. Hope that helps

Sumanth Pagadala, MD (retired) · Answer

Thanks for your question about arm lifts. I normally do liposuction in conjunction with brachioplasty (arm lift) unless the patient has no fat at all, only skin. In that case just brachioplasty alone. Most patients need some liposuction even if its minimal. I rarely use drains after brachioplasty. This procedure is done in my surgery clinic on an outpatient basis. Good luck to you.

Peter Fisher, MD (retired) · Answer

Hello and thank you for your question. All surgeons get comfortable in doing procedures the way they feel gives them good results. You need to choose someone you are comfortable with. I nearly always do suctioning at the same time if needed and never use drains. I also do this as an out-patient procedure.

Arm lift: Drains or no drains? Lipo or no lipo? I have consulted 2 doctors and am confused as their approach is very different

Answers (8)

More Arm Lift Questions

Can I still tone my arms after brachioplasty? (Photo)

Excess skin & fat btw breast and armpit after brachioplasty, crepe-like skin, can this be removed or corrected at all? (photos)

Would anyone be interested in pro bono patient, if you can help in any way, maybe discounted rate, please.

What can I put on the open wound under my arm pit to get this to heal? (photos)

Dog ear near elbow after Arm Lift surgery. (photo)

Can a brachioplasty incision be done under armpit if the arms just require a lift to tighten the loose skin?

WE SEND PRETTY
EMAILS