Arm lift revision or liposuction for fat above the elbows? (Photos)

Question

I have always struggled with arm fat right above my elbows. I lost a considerable amount of weight about 16 years ago that left my skin a little very loose. In 2017 I was able to get an arm lift, which improved the loose skin on my arms. However I saw very little improvement in spot above my elbows. I've tried working out my arms to get rid of get fat there but I only see definition in my upper arm area. I'm wondering if I need an arm lift revision or liposuction?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your pictures and question regarding whether you need an arm lift or liposuction to remove the fat above your elbows. It is essential to realize that your skin does behave like a patient who has not lost a significant amount of weight. That means if liposuction is performed in this area, specifically your elbows, the skin will not retract. Therefore, I would not suggest elbow liposuction. Instead, I would suggest an arm lift revision. I would suggest taking the area around the elbow and making an incision behind the elbow. Above the elbow, this would be approximately 4-5 centimeters and perpendicular to your original scar. It would go from your prior arm incision around the elbow and in the back and above the elbow. This would get rid of the excess skin and fat above the elbow. If you also wish, the entire arm lift can be revised from the armpit to the elbow. However, that is not completely necessary if you are satisfied with your arm lift results. The incision from the armpit to the elbow with the extension around the back of the elbow is often called an arm reduction or brachioplasty. Thank you for your question regarding whether you need an arm lift revision or liposuction for fat above the elbow. 
Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Miguel Mota, MD · Answer

Hello! An Arm Lift revision is best. Lipo will only get rid of fat and therefore leave you with more excess skin. Exercise also reduces fat and it will tone your muscles but it will not tone your skin. You can repost your question with new front photos with your arms open so we can evaluate better. In any case I do believe an Arm lift revision is your best option.

Best of luck,
Dr. Miguel Mota

Best of luck,
Dr. Miguel Mota

Daniel Barrett, MD · Answer

Dear sledouxx,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

An examination is needed to see if this is mainly fat or skin. With fat, liposuction could be done and Renuvion could be added to tighten skin. A small incision would be used for both. If this is skin, a small tuck could be done in that area.  go visit with a plastic surgeon.

Andrew T. Cohen, MD, FACS · Answer

I would offer revision arm lift and lipo around the elbow. I don’t like to put a scar around the elbow as it can not heal great..so just some lipo.

You should do very well.  See a board certified plastic surgeon

Good luck !

Andrew Cohen, MD

Nancy de Kleer, MD, FRCSC (Plast) · Answer

I recommend you have an in person assessment where your skin tone and the fat pocket can be assessed.
If the skin is not too stretchy, liposuction is a good option.
If the skin is a bit stretchy, Coolscupting may be a better option as the fat will disappear more slowly than with liposuction, allowing the skin to bounce back better.
If the skin is very stretchy, a revision arm lift with liposuction at the same time is your best option. 
All the best to you,
Dr. Nancy de Kleer

Camille Cash, MD · Answer

Your photos indicate that the culprit is more loose skin than fat.  Liposuction will only address the fat and will leave you with potentially more loose skin.  The arm lift revision will likely give you the best results.  See a board certified plastic surgeon near you to learn more.

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