Minimal Incision Brachioplasty

I just recently lost about 45 pounds and I noticed that I have minimal sagging and stretch marks on my arms. I inquired to a plastic surgeon about this and she said because it is minimal and I am so young (20 years old), it would not be worth the scar. Is there any solution to my problem that is not as severe? Would any among Mini Brachioplasty, arm toning with exercise, or laser skin tightening be a good option for me? Any advice would help seeing as I am very insecure about this and would like to handle it now while I am young.

Doctor Answers 33

Start with toning your arms through exercise

The arm lift or Brachioplasty leaves a long scar extending from axilla (armpit) to the elbow. As with any cosmetic surgery it is a trade off: is the scar worth the improvement in contour? For women who have lost a lot of weight and have a lot of hanging skin (bat wings) on their arms, the scar is very worth it. For women who have only a little loose skin the scar would not be worth it. At your age, with only a little loose skin, I think with some exercises to tone up the arms ( think Michelle Obama!) you will probably see quite an improvement and enjoy your new contour.

Los Angeles Plastic Surgeon
3.9 out of 5 stars 9 reviews

Sagging arms need arm lift

The best indication for an arm lift, and the most gratifying are those who have lost a lot of weight.  The skin is usually flabby and overstretched.  It is simple and effective to remove the skin that has been stretched past its capacity.  No Liposuction, or other noninvasive modalitiy will help the skin become more firm around the arms.  The length and type of the incision will vary depending upon the location and the amount of fat in the arms.  The cost will also vary by geographic locale.  Most will run anywhere from $3500-$7000.  I would advise you to visit with a board certified plastic surgeon to have treatment recommendations specific to your concerns.

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.3 out of 5 stars 34 reviews

You can be better.


You can definitely be helped.  I would recommend an agressive type of liposuction in which very little fat would be removed circumferentiallly, at which point the suction machine would be turned off.  The canula, which is the name of the instrument used for liposuction, would be passed back and forth to injure the under side of your skin to stimulate contraction of your skin.  After the surgery you would have to wear a conpression garment for a minimum of 6 weeks and preferably 3 months to hold the skin in place and allow it to contract. This should give a very nice result.  If there is still some residual skin, this could be removed with a mini-lift either at the time of the initial surgery or at a later date.

E. Anthony Musarra II, MD
Atlanta Plastic Surgeon
4.2 out of 5 stars 12 reviews

You have options

The key point in the decision is the condition of the skin elasticity. If you have minimal laxity, you may do well with liposuction, or perhaps ultrasound assisted liposuction. This will get rid of excess fat, while encouraging the skin envelope to shrink to the smaller form.

A mini-brachioplasty, as I define it is one that places theincision in the axilla (arm pit) at a right angle to the long axis of the arm. A full brachioplasty extends the incision down the upper arm toward the elbow. I usually do lipo in both instances.

The mini will only tighten skin/tissue from elbow to axilla, while not addressing the skin that hangs down.

You have choices, but you must be evaluated, and surgical planning must take into account what you wish to accomplish, and what you are willing to put up with. The full brachioplasty leaves a visible scar, but if you are OK with that, you may be happy with the result.

I have enclosed a link to my old web site for you to see what is possible.


Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.7 out of 5 stars 101 reviews

Sagging arm skin

Thank you for your question regarding sagging arm skin. It is difficult to answer your question fully and accurately without pictures. If you want a surgical solution, I would suggest a crescent or limited T incision brachioplasty. In either case, a minimal amount of skin and fat are removed. The scar is usually well hidden in the axillae. If you do not want arm surgery, I would suggest exercise. I have not seen conclusive results from the arm laser.

Good luck with your quest for skinnier arms.

If you have any questions, please do not hesitate to contact my office.

Sincerely, Dr. Katzen

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 195 reviews

Mini Brachioplasty

If you have minimal skin laxity and excess fat you may be an excellent candidate for SAFE Liposuction with or without a mini brachioplasty which is a small scar located in the axilla which excises the majority of the sweat glands, as well. In my patients, it has been very effective in reducing fat and simultaneously reshaping the arm to a smooth cylindrical shape which most women desire.  We usually treat the scar postoperatively with a combination of silicone gel treatments with erbium laser resurfacing and obtain excellent results with this combination. 

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 75 reviews

Surgical Options Best For You

                  It’s not unusual for patients to develop excess arm skin after significant weight loss. When this occurs it can represent a significant aesthetic deformity that’s not easily hidden. In most cases treatment involves removal of excess skin but treatment is frequently associated with noticeable scarring of the arms. Patients are often motivated to avoid this scarring by utilizing less aggressive procedures.

                  Without being able to perform a physical examination, it’s virtually impossible to make a specific treatment recommendation. Unfortunately, after a 45 pound weight loss, a more aggressive procedure is probably indicated. Several surgical options exist for treating this condition, including liposuction, mini brachioplasty and full brachioplasty. The procedure chosen is dependent on the patient’s aesthetic goals and their specific anatomic findings.

                  In some cases, liposuction may be a viable alternative. When this procedure is utilized, scarring is minimal and results are usually excellent. Unfortunately, this procedure is only effective when fat is present and the skin is relatively tight.

                  When excess skin is confined to the upper arm in the area of the axilla, a mini-brachioplasty may be effective. This procedure utilizes an incision in the upper arm which is transversely oriented and well hidden. The procedure is helpful when patients have minimal excess upper arm skin and is associated with excellent results.

                  Unfortunately, the vast majority of patients who have had significant weight loss require more extensive procedures. In most cases, this involves a full brachioplasty with an incision that extends from elbow to axilla. This procedure addresses excess skin in the vertical and transverse dimensions. In most cases, results are excellent, but occasionally adverse scarring can be a problem.

                  When significant excess skin is present, laser tightening and other non-surgical treatments aren’t effective. For this reason, patients who have significant arm skin sag should consult a board certified plastic surgeon who can formulate an appropriate treatment plan. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

There are options for arm toning.

Congratulations on your weight loss.   At 20 years old and with a 45 lb weight loss, your skin tone is most likely reasonably good shape.  The four things that contribute to upper arm laxity are poor muscle tone, excess fat, excess skin and loose fibrous connections.  Your first step should be to try to improve your muscle tone with exercise and weights to see if this does the trick.  If unsuccessful, in young patients a combination of laser liposuction and a non-ablative skin tightening procedure such as skin tyte can be very effective.  In moderate skin excess cases an arm lift is the best option.  In severe cases an arm lift with staged or adjunctive liposuction is necessary.  Minimal incision armlifts often under-deliver and leave patients unsatisfied with the results and the scars.  An in person consultation is your best option for determining an appropriate plan.  All the best.

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 77 reviews

Short Scar Brachioplasty great procedure for the right person

If there is limited fat and loose skin close to the arm pit then a short scar technique also called a "minimal incision Brachioplasty, leaving the final scar in the arm pit may be possible.It is a great procedure for the right person.

This is to be compared with a traditional arm lift, brachioplasty, where Incisions are placed in a subtle location on the underside of the arms, between the armpit and the elbow.  General anesthesia is usually used for this procedure.  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. 

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Hidden Inner Armlift

The hidden inner armlift is not good for patients with massive weight loss as they have significant posterior arm redundancy. The hidden inner armlift is only good for mild to moderate inner arm laxity or the inner third of the arm. None of the non-evasive skin tightening or laser procedures work in this area.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 63 reviews

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.