Which selection for placement of arm lift scar is better, inside or back of the arm?

Question

I am meeting with a few surgeons regarding brachioplasty. Some offer placement on the inside of the arm from the armpit to the elbow. While others choose placement on the back of the arm. Which selection is better and why? Thank you in advance for taking my question.

Paul M. Steinwald, MD · Answer

Some of us plastic surgeons of a certain "vintage" will tell you many of us were taught to place the arm scars on a longitudinal brachioplasty relatively high in the "bicipital groove" (muscular "hollow" of the arm when it is outstretched at 90-degrees), but better than that or a seam down the back of the arm (easily seen from behind), my approach has evolved to a lower-anterior arm position, somewhat difficult to see even when the arm is out (unless doing the "beauty-pageant wave" for an extended time), as seen in the photos attached. This also doesn't limit any functionality (although I believe in tailing above the elbow area if necessary - so not leaning on it easily, and doesn't disturb the "funny bone" region - plus usually darting the incision into the posterior axilla if there is significant skin in this area as well).

J. Timothy Katzen, MD, FACS · Answer

Hi Wednesday5, 
Thank you for your question regarding which selection for placement of arm lift scar is better, inside or back of the arm?  Plastic surgery is all about hiding scars.  Arm lift scars placed on the inside of the arm are MUCH more aesthetically pleasing than back of arm lift scars.  Most people hold their arms by their sides,  If an arm lift scar is placed on the inner portion of the arm, when the arms are held by your side, the arm lift scars are hidden.  However, if you place the arm lift scar on the back of your arm, when your arms are by your side, your arm lift scars are highly visible.  In general, if the arm lift is performed correctly, you will barely see the any scar after one year.  SIlicone gel, silicone strips, and compression garments are key to minimize arm lift scars.

I hope that I have answered your questions regarding the arm reduction and which selection for placement of arm lift scar is better, inside or back of the arm?  If you have any more questions regarding the arm lift, arm reduction, brachioplasty or arm crease fat grafting, please contact my office.  Since a brachioplasty or arm lift surgery is a difficult procedure, please seek an experienced, board certified plastic surgeon with significant experience performing these types of arm lifts. Do your research.  Make sure your chosen plastic surgeon has performed at least 100 arm lifts.  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. (Plastic Surgeon, President of the American Society of Bariatric 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, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Caner Kacmaz, MD · Answer

In my practice, I definitely prefer the inner arm straight line scar for my patients. This technique permits us to take out a significant amount of excess fat and skin.
 We can reshape the entire upper arm, making it look much firmer and toned.
The scar is visible however it is inside part of your arm and eventually fades away in time.

David Branch, MD · Answer

Thank you for your question.,  Ideally, the best place for a somewhat hidden incision is underneath the arm.  Where a seam in a shirt is.  This way, the incision is more hidden and will transition into the armpit.  Either would be fine, it's mostly provider preference and how they were likely taught.  Good luck!

Jeffrey M. Darrow, MD · Answer

Incision placement should be chosen by you after a complete discussion.  Either incision can give an excellent result.  The incision on the inner arm is well hidden most of the time, except when you raise your arm, ie waving good-bye.  The incision on the back of the arm is visible from behind, like when you are walking away.  I have performed both and patient satisfaction is high, as long as patients understand what to expect.  Best wishes.

Azita Madjidi, MD, MS, FACS · Answer

The arm does not like to be cut in general. I never put my incisions in the front or the back because we know the scar will be not like a tummy tuck scar. I put mine at the edge of the arm so when the arms are in normal position, you can't see them from the front or the back.

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question here!There are different acceptable ways of performing a brachioplasty. The scar can be in the medial side, posterior side or in rare occasions when minimal lift is required it can be isolated to the axilla. That being said it will depend on your preferences. The posterior one will be visible wether you raise your arms or not while the medial one is usually visible when you raise your arms.
I hope this helps , best of luck!

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs. However, a brachioplasty can be done in a few ways. What is commonly done is liposuction is done at the time of brachioplasty to create a dissection plane and the incisions are either made long (from the axilla down the arm to the elbow) or transverse (at the axilla only). I do not place the incisions on the back of the arm as the scar is more visible there.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

I prefer to place the scar from the armpit to the elbow so that is not noticeable when your arms are down by your sides, either the front or back view.

Camille Cash, MD · Answer

Typically for a full brachioplasty patients select the scar that runs from the underarm area down the inner aspect of the arm to the elbow.  When the arms are in a relaxed position at your sides the scar is not visible.  Discuss the options with your surgeon to help determine which is best for you.

Which selection for placement of arm lift scar is better, inside or back of the arm?

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