Brachioplasty Techniques?

I'm having brachioplasty surgery. I have received conflicting opinions on Different techniques. Is it best for the incision to be in the brachial groove or in the back of the arm? And why?

Doctor Answers 11

Brachiplasty Incision Placement Experiment

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There are two schools of thought regarding brachiplasty incision placement, the brachial groove or the posterior arm camp.  Both can yield good contour correction.  If you look at postop photos from the posterior arm camp, the contour of the arm is nicely corrected, but there are no scars visible in the standard views.  Unfortunately, in social settings  such as a supermarket line, the posterior scars are very visible and attract a lot of attention.  In contrast the medial brachial groove incision is only visible  when the patient is waving or arms are up in postop photos. Most people keep their arms at the side most days.  In this position the scars are not visible from the back, sides or front.  Over time the medial scar fades well and most patients begin wearing short sleeve or sleevless clothing...this would be hard with a posterior scar.  To answer this question definatively for your self, take a sharpie and put a thick black line on the inside of one arm and the back of the other arm.  Wear it for a week in public and see which one attracts the most attention.  That should help you answer your question in an unbiased way.  Hope that helps.

Fairfax Plastic Surgeon
4.6 out of 5 stars 59 reviews

Brachioplasty techniques?

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In my opinion the best placement for the incision is in the upper inner arm approximately two thirds of the way down from the top of the extended arm. 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. This operation is normally performed as an outpatient. It is very important for the surgeon to discuss the resultant scar thoroughly with the patient preoperatively. Very commonly this scar takes a longer time to undergo the full healing and maturation process. Maturation refers to the process whereby the scar becomes less apparent. Brachioplasty scars commonly take up to 2 years to fully mature. It will be very important to choose a surgeon who is Board certified by the American Board of Plastic Surgery and has extensive experience in all forms of body contouring. Good luck.

John J. Edney, MD
Omaha Plastic Surgeon
4.8 out of 5 stars 133 reviews

Incision Placement Choices for Arm Lift Surgery

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The best position in my opinion for a traditional brachioplasty, arm lift, is when they are hidden with you arms at your side.

Incisions are placed in a inside location on the underside of the arms (the part of the arm that is against the body with the arms hanging at their side), between the armpit and the elbow.  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. If there is limited fat and loose skin close to the arm pit then a short scar technique leaving the final scar in the arm pit, axillary, crease may be possible

Incision location for brachioplasty

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The best incision line is the one the patient chooses.  There are no right answers, but arms with less skin excess can get by with shorter scars.  In many cases I try to limit the scar to the armpit with no extension down the arm.  Make sure you consult a Board Certified Plastic surgeon and be sure to see a comprehensive portfolio of pre- and post-op pictures so you can see what results are typical.

Arm Lifting Scar Concerns?

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Thank you for the question.

 There is not necessarily a right or wrong answer here. My preference, having done the operation  using both “techniques”, is to plan the excision such that the resulting scar falls  along the most inferior aspect of the arm;  the goal is to make it so that the resulting scar is not visible from the front or back. In comparison, I find that the scar in the bicipital groove will be visible from the front.

 Unfortunately,  regardless of where the scar ends up,  arm lifting scars can spread, requiring revisionary surgery to improve the results.

 I hope this helps.


Arm lift

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I like the brachial groove scar, because I think the scar is less noticeable there.

There is not a "better" choice, just whichever your surgeon prefers.

Brachioplasty Technique

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   In an extended brachioplasty, I can put the scar anywhere the patient desires.  It is my belief that the incision in the bicipital groove is the most appropriate in most patients as most people during casual observation do not expose the medial aspect of their arms.  The posterior scar is more visible in walking in short sleeve shirts.  With regard to nerve injury or vascular injury, I have never seen one, but this is more the result of the dissection and not the placement of the scar.  Kenneth Hughes, MD Los Angeles, CA

Arm Lift Scar Placement

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One of the most important considerations before an arm lift is the tradeoff of better shape and contour for the chance of noticeable scars.  While there is no "correct" answer to your question, I have found that scars placed on the back of the arm are preferable for two reasons.  First, they cannot be seen when someone is standing in front of you, which I believe makes them less conspicuous overall.  Secondly, the posterior scar approach allows for contouring of the area where the upper arm meets the side of the chest, and this can be important to patients with a lot of loose skin.  With that that said, you can get great results with either technique, and the most important consideration is to have a board certified plastic surgeon evaluate and treat you.  Good luck!    

Mark Schwartz, MD
New York Plastic Surgeon

Brachioplasty scars

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I always tell weight loss patients who are undergoing brachioplasty that there is a trade off for loose skin in the arms versus the scar ... So if you don't want to see the scar from behind with arms at your sides, then we place it in the biceps area..

Sanjay Lalla, MD, FACS
West Orange Plastic Surgeon
4.8 out of 5 stars 51 reviews

Brachial Groove Incision Most Hidden

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Thank you for your question.  There are advocates for both incisions.  The benefits of the brachial incision is that with time it heals well and is hidded from all views when the arms are down. It is only visible when the arm is raised.  The posterior incision looks good on postop photos as the incision does not show, but when your arms are at your side and you are wearing a short sleeve, the incision is visible from the back.  This can be embarassing when questions are asked at the supermarket.  In skilled hands, you can achieve an excellent result with either technique, but patients are better served long term with a medial rather than posterior incision.

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.