I'm concerned with scarring - Is an arm lift the only solution for my arms? (Photos)

Question

I'm a 45-year-old woman (5'7", 147 lbs) concerned about the appearance of my arms. I've researched AirSculpt, liposuction , and arm lift surgery but am unsure which is best for addressing fat and skin. My main concern is scarring and being left with uneven arms, particularly with brachioplasty. Any thoughts?

J. Timothy Katzen, MD, FACS · Answer

Hi Vivid122862, Thank you for your question regarding is an arm lift the only solution for your arms.  Thank you for your history and your pictures.  First, we should analyze your pictures to determine the best arm procedure.  You have mild lipodystrophy (excess fat) from the axillae (armpit) to the elbow.  You have mild cutis pleonasmus (excess skin) and dermatocholosis (loose skin) from the axillae (armpit) to the elbow. You do not appear to have arm stretch marks.  Do you have a history of significant weight loss of over 100 pounds?  Do you have any other medical problems?  Most experienced board-certified plastic surgeons would not recommend a brachioplasty (arm lift or arm reduction) in your case.  Most experienced board-certified plastic surgeons would recommend VASER liposuction or VASER Hi-Def arm liposuction.  VASER is an acronym that stands for Vibration Amplified Sound Energy at Resonance.  A VASER is basically an ultrasound probe.  The VASER is a powerful addition to liposuction.  The VASER helps liposuction results by melting the fat and heating the skin for maximum benefit.  In your case, you should undergo VASER arm liposuction.  "Traditional" VASER arm liposuction can help you achieve slender, feminine arms.  Another alternative to "traditional" VASER liposuction is VASER Hi-Def arm liposuction.  During VASER Hi-Def arm liposuction, the VASER is used to sculpt the muscles and remove the fat between the deltoid, triceps, and biceps. The results of VASER Hi-Def arm liposuction are sculpted, athletic arms.  The degree of muscle definition will be determined by you and your chosen plastic surgeon before surgery.  The procedure takes about 2 to 3 hours under general anesthesia.  Plan on a 7 to 10 day recovery.  You will need to wear arm compression sleeves for 6 to 8 weeks for maximum results.  Lymphatic massage and hyperbaric oxygen can help to accelerate healing and final results.  
I hope that I have answered your questions regarding the arm reduction.  If you have any more questions regarding the arm lift, arm reduction, brachioplasty, or arm crease fat grafting, contact an experienced plastic surgeon.  To get an accurate assessment of what exactly you need, schedule a free virtual consultation.  Most plastic surgeons offer free virtual consultations.
Since an arm lift can be a challenging surgery, please seek an experienced, board-certified plastic surgeon with significant experience performing these types of lifts. Do your research.  Make sure they have performed at least 100 arm lift procedures.  Make sure they have the before-and-after pictures to prove it.  Carefully examine their before-and-after pictures and check their reviews on RealSelf.   Sincerely, Dr. Katzen, MD, MBA, FACS, FICS ( 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, International College of Surgery, and American Board of Metabolic and Bariatric surgery,  and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Ellen Ozolins, MD · Answer

Thank you for your question. If your concern with the upper arm is mainly excess fat and your skin has good recoil, then targeted liposuction is the best first option. Adding radiofrequency tightening treatments, such as BodyTite, Renuvion, or RF microneedling, can help with mild laxity and reduce the risk of post-lipo crepe or ripples. “AirSculpt” is a marketing term for power-assisted liposuction&mdash;results depend more on the surgeon than the device. If an exam reveals moderate to severe skin excess, only a brachioplasty reliably tightens the skin; however, it does leave a scar along the inner arm. Schedule an in-person evaluation with a board-certified surgeon to assess true skin laxity versus fat, pinch thickness, and skin quality so you can choose between liposuction with or without RF tightening versus a lift, based on your tissue condition and scar tolerance.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Harry T. Haramis, MD, FACS · Answer

In my experience, many similar patients avoid arm lift  and achieve nice contour with Vaser ultrasound liposuction.

This will remove stubborn fat, reducing arms and tightening skin (to a degree) without a large scar from skin removal. There is always some left to right differences anatomically before and after any procedure, but better symmetry is always a part of the plan.

An exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations.

Camille Cash, MD · Answer

You may want to explore BodyTite.  This minimally invasive procedure uses RF technology to tighten skin.  It can be combined with liposuction as well.  The procedure does not require general anesthesia and scarring is minimal.  I've included a video I hope you find helpful.  Another option is liposuction with J-Plasma for skin tightening.

Darryl J. Blinski, MD · Answer

Based on your posted photos, you could try liposuction with plasma to see if enough skin tightening is effective expect that feed range from $5000-$8000. A full break plasty gives you the best results but there is a permanent scar that you have to be OK with. That fee is $8000-$10,000. Best virtual consult with for better understanding.

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