Is it common to do an arm lift without lipo?

Question

My doctor said I don't need lipo on my arms only an arm lift. He did say I had some fat in my arms but he doesn't do arm lipo because it causes your arm to swell too bad. Why would swelling matter if it eventually goes away? Does it impact the results /scar? Is that common / correct? I thought they always did lipo with an arm lift.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether liposuction is commonly done alongside an arm lift. In my practice, I almost always combine liposuction with brachioplasty unless the patient has primarily excess skin and little to no excess fat in their arms. Liposuction helps contour the arms more precisely by removing stubborn fat deposits that an arm lift alone may not fully address.

Swelling after liposuction is a normal part of the healing process and, while it does temporarily increase recovery time, it does not typically impact the final results or scarring if managed properly. Compression garments and proper postoperative care can help reduce swelling and ensure an optimal outcome.

It’s uncommon for surgeons to completely avoid liposuction during an arm lift unless there are specific medical concerns or the patient truly has minimal fat. In most cases, combining liposuction with an arm lift leads to smoother, more sculpted results.

If you’re unsure about your surgeon’s approach, it’s okay to seek a second opinion to ensure you’re confident in the treatment plan. A personalized evaluation will determine whether liposuction is appropriate for you.

Sincerely,
Dr. Katzen

Christine Rodgers, MD · Answer

Hi mariefl!
Arm lift surgery can be performed with and without liposuction. This is patient dependent based on how much excess skin vs fat is present. The doctor you met with is correct in the fact that there is a fine line with how much swelling can be present after surgery as we do not want to stretch out the skin that previously had laxity. I would suggest getting another opinion from a board certified plastic surgeon to see if they agree with this recommendation with the goal of meeting your expectations. Best of luck!

Caner Kacmaz, MD · Answer

In most cases, arm lift patients do not need liposuction because there's no excess fat to be removed. On the other hand, patients who have relatively good skin elasticity may only need liposuction or minor tightening rather than arm lift. 
In your case, your surgeon probably decided that the amount of fat you have is not significant enough for liposuction.

Dana Goldberg, MD · Answer

I have started to incorporate liposuction into nearly all of my arm lift procedures. However, I usually limit this to the area of the tissue I am removing. This helps to skeletonize the vessels and nerves so that as many of them can be preserved as possible. It is only rarely that I will do liposuction outside the area of skin removal for exactly the reason your surgeon stated. In the cases where I do liposuction outside the area of skin removal, I highly recommend lymphatic massage both before and after the procedure to minimize swelling. Other options to remove fat include doing liposuction before the arm lift (which can often be done under local anesthesia) or performing Cool Sculpting to the area before or after the arm lift.

Chet Mays, MD · Answer

Thank you for your inquiry!  Liposuction does cause post-operative swelling.  This could lead to pulling on the incisional area.  We would love to sit down with you and discuss your concerns. Schedule a consultation with a Board-Certified Plastic Surgeon to discuss your goals.

Jeffrey M. Darrow, MD · Answer

Liposuction is usually performed during an arm lift to: 1) remove the fat that is between the lines of the skin resection pattern of the arm lift so the edges of the skin can come together easily, 2) to decrease the arms volume and shape the arm better.  Volume reduction of the arm is needed as trying to create a thinner arm by wrapping the arm skin tightly around the arm does not thin it and leads to worse scars.  There is some swelling of the arm that occurs after arm lifts but it is self limiting and resolves.  If you are very thin, you may not need liposuction but the majority of patients improve their results if liposuction is part of the procedure.  Best wishes.

Simona V. Pautler, MD · Answer

Some arms are bulky but have good elastic skin and get a great shaping result with Lipo alone. Other arms, especially from weight loss or older patients with crepe like skin, have very little fat and just need aggressive skin tightening alone. Then there are arms in between. Lipo removes fat, but does not have any real beneficial effect on arm skin so sometimes the skin needs removed too. Lipo does indeed cause some swelling which can put added tension on the incision of an arm lift and this can have a detrimental effect on scar quality. So swelling does matter because your doc probably wants you to have the best scar possible. Also, some docs stage the Lipo, either they do it first, and then let the arm swelling settle and then do the skin removal, or vice versa.

Dallas Buchanan, MD · Answer

I am sure you are going to find answers both ways as it really comes down to surgeon preference. I prefer to do liposuction with all my arm lifts. I think it helps to contour the areas outside the skin removal. I also think that it makes the dissection of the skin removal easier and safer. But, it is not wrong to not perform liposuction with an arm lift, lots of surgeons do it that way. Make sure that you trust your surgeon and let them do what they do best!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Carmina Cardenas, MD · Answer

I perform liposuction in a 100% of my patients who are having arms lift, to reduce the thickness of the arms and also to preserve vessels, nerves and lymphatics and prevent patients end up with chronic pain. 
Be encouraged!
Dr. Cardenas.

Kristopher Hamwi, MD · Answer

I find that liposuction is often necessary to get the best results. This is not alway the case if you have small arms already but shrinking the arms with liposuction allows more skin to be removed and gives a smaller more shapely result. Liposuction in the upper arm can be tricky and I think it is often needed on the outside of the arm where fat can accumulate. If this is not addressed then I find that I would be missing an important component of achieving the optimal result. Check out these videos below to understand more.

Is it common to do an arm lift without lipo?

Answers (17)

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