Arm Lift Scar Position Favored by Most Women?

Question

I know it depends greatly on the individual, but  could you give me an idea of which Arm Lift scar position is favoured by most women, inner arm incision or incision at the junction of the inner and posterior aspects of the arm? I read that the skin on the back of the arm is tougher  than inner arm skin and the scar may be pulled more centrally to the back of the arm. Is that a frequent complication? Thank you.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding arm lift or brachioplasty scar placement.  This is an excellent and frequently asked question. Any scar should ideally be placed in a concealed area whenever possible. Whether it is a facelift, rhinoplasty, breast lift, or thigh lift, plastic surgeons always try to hide the scars.  Arm lifts or brachioplasties are no exceptions. I always try to hide the scar in the groove between the bicep and the triceps fold. This is on the inner portion of the arm. A scar placed in this region is much more concealed than a scar placed on back of the arm or posterior aspect of the tricep muscle. Typically, we carry our arms by our sides. When you hold your arms by your side, the arm lift scar is hidden. If the arm lift scars placed on the back of the arm, in the triceps region, the scar is extremely visible when you wear short sleeve shirts and your back is turned to the viewer.
Technically, it is easier to place the incision on the back of the arm. I believe this is why some surgeons perform the arm lift in this fashion. However, I believe the arm lift scar should be concealed.  Even though the surgery is technically a little bit more difficult to perform on the inner arm, the results are better than a arm lift scar placed on the posterior portion of the arm.  
To answer your specific questions, the posterior portion of the arm maybe thicker skin, but that does not mean the incision should be placed there. I have never had a scar "pulled more centrally to the back of the arm". Therefore, in my practice, this complication does not happen.
Good luck with your quest for skinnier arms.  
If you have any questions, please do not hesitate to contact my office.  
Sincerely, Dr. Katzen

Richard J. Bruneteau, MD · Answer

When
women undergo brachioplasty surgery an incision is made from the elbow to the
axilla. Through this incision, excess skin and fat can be removed in both the
transverse and vertical dimensions of the upper arm. The exact placement of
this incision is dependent upon several variables.

In
the majority of cases, the incision is placed on the inner arm between the
biceps and triceps muscles. In this position the scars are well hidden when the
arms are at the patient’s side. When patients raise their arms, the scars
become more noticeable.

Occasionally,
women prefer scars that are more posteriorly located. In this position, scars
don’t tend to spread as much because the skin is thicker in this location.

It’s
important to understand that scarring is inevitable with this procedure,
irregardless of the incision placement. The most important variable in scar
formation is the patients wound healing biology. This varies from patient to
patient and for this reason incision placement needs to be individualized.

If
you’re considering brachioplasty, it’s important to discuss these issues with a
board certified plastic surgeon before proceeding. This surgeon should be able
to formulate a treatment plan that addresses this issue.

Rod J. Rohrich, MD · Answer

There is primarily an inner arm scar which is a minimal armlift, however, it is used in patients with moderate lipodystrophy and not for patients with extensive skin lipodystrophy.

William Bruno, MD · Answer

The location of the scar for an arm lift (brachioplasty) varies depending on a patient's anatomy and skin laxity.  Generally the scar is located on the medial or inner aspect of the arm, extending from the elbow to the armpit.  Sometimes this scar can located slightly more posteriorly or towards the back of the arm.  The goal is to provide a good contour while at the same time concealing the scar when the arm is down by the patient's side.  Regardless of where the scar is located, patient's must realize the scar can potentially be permanently dark in color and may be slightly thick.  This is a tradeoff , meaning you will have a better contour but may have a noticeable scar.

	Please consult with a board certified plastic surgeon to determine if you are a candidate for this procedure and to discuss in detail the position of the final scar.

	Best wishes,

	Dr. Bruno

Boris M. Ackerman, MD · Answer

Before making a final decision on scar placement, the surgeon needs to analyze the arm anatomy.  Typically there is skin excess both in circumferential dimentions ( lilke the sleeve is too bit, skin hangs from lifted arms), and in longitudinal dimentions, (like the sleeve slipped down the arm).  Both of these issues need to be addressed.

	The surgeon will advise you on ideal scar placement.  Typically plastic surgeons have been taught to leave the final scar just below the biceps muscle, but that is not the ideal placement for the scar. For most of my patients, the final scar should lie on inner aspect of the arm towards the back.  This placement of the scar is least noticeable in most arm positions.

Scott C. Sattler, MD, FACS · Answer

Most women with arm skin laxity look best with a 'long scar' brachioplasty which addresses all of the skin laxity along the length of the upper arm. This can also be extended into the armpit and upper thorax region to address the laxity that women frequently have in this region. I place scars in the bicepital groove- which is the groove below the biceps muscle along the inner aspect of the arm. Scars that are placed lower than this level tend to migrate toward the back of the arm and can be visible from the back of the patient.

Farbod Esmailian, MD · Answer

I think this is the same, there is no different between the inner arm and the junction of the inner and posterior incision.

	There are really two places to put the incision, one is the inner aspect of the arm, the other is on the posterior aspect. By far, the most cosmetically appealing position for this incision is the inner aspect of the arm.

John J. Edney, MD · Answer

Brachioplasty or arm lift surgery is one of the most frequently requested body contouring procedures performed today.  The demand for this procedure has increased more than 800% since 1997.  This is the greatest percent change of any of the commonly performed cosmetic surgical procedures  Much of the increase in popularity is due to the growing number of patients who undergo massive weight loss.  In performing this procedure an incision is made on the inside of the arm extending from the elbow into the armpit.  Sometimes it is necessary to extend the incision further into the armpit and sometimes past it.  Utilizing this incision excess skin is removed and the wound is closed.  It is very important to position the scar properly so that it is concealed as much as possible.  A well-placed incision should result in a scar that is only visible when the arms are raised.  The scar usually ends up in the lower one third of the inside of the upper arm.

Tom J. Pousti, MD · Answer

The arm lifting procedure is a great procedure to remove excess skin and adipose tissue of the upper arms. However, this procedure carries a major drawback: difficult scarring that may require scar revision (more so, in my experience, then other procedures).

	I have tried placement both placements of the resulting scars in the bicipital  groove (between the biceps and triceps muscles)  as well as a long the inferior&ndash;lower aspect of the upper arm. I have found higher patient satisfaction with the latter approach. If the excision can be planned such that the scar falls along the frontal aspect of the lower arm, then the scar may be visible only when the patient raises his/her arms.

	As with many plastic surgical procedures, the planning of the incisions and resulting scar line is critical. However, even with attention to detail, the resulting scars may not be ideal and revisionary surgery is  often necessary to improve the appearance (for example, the width) of the scars.

	Thank you for the question&ndash;I hope this helps.

Susan E. Downey, MD · Answer

For a full arm lift (also known as a brachioplasty) the scars run from the elbow up into the armpit and often down the side of the chest to the bottom of the bra line. The scars can be placed in two positions - on the back side of the arm or on the undersurface of the arm. Different surgeons have different preferences. The more posterior scar is visible when the arms are down at the side while the scar along the undersurface of the arm are visible when the arms are raised. Since the scars usually extend down to the elbow they are usually visible even in short sleeves. For some reason the scars near the elbow (which are of course the more visible scars) take longer to "settle down" and can be thick and ropey for a long time . The scars near the armpit improve faster. This is frustrating as one would like the more visible scars to improve the fastest! Since there are significant scars from a brachiopolasty there should be a significant improvement in contour to justify the permanent scars.

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