Any promising new techniques for arm lifts?

Question

I know about the underarm tuck, but that won't work (apparently) for many/most weight loss cases. In my case, 45-50 lbs. Good musculature underneath but prior lipo without removing skin not effective. The arm lift scar is a bit barbaric in appearance. Are there any alternatives on the horizon?

Richard H. Tholen, MD, FACS · Answer

How do your arms look after deflating liposuction? Unnecessary and poor-result operations upset all of us who want the best results for our patients, not just their money.There is no laser, external RF, smartlipo, or other new technology that can even come close to a reasonable result that compares to surgical excision of the loose skin via brachioplasty.Yes, the scars are often atrocious, but "barbaric" is too much! Careful closure and proper placement are critical components of a satisfactory outcome. This is a technique-responsive operation because of the thin and crepey nature of the skin in this area. Closure is difficult, and the thin skin heals poorly with even the tiniest bit of inflammatory stimulus. Silicone sheeting is not a cure for a bad closure, but it can salvage a good one that might still be healing with hypertrophy in a genetically-prone individual.Remember, surgeons of the "olden days" were barbers, not butchers! Best wishes! Dr. Tholen

J. Timothy Katzen, MD, FACS · Answer

Hi, 55 and counting. In Auburn, CA, thank you for your question about promising new techniques for arm lifts. Thank you for your history. Without pictures or a physical examination, you have bilateral arm cutis pleonasmus (excess skin) and dermatocholosis (loose skin). In short, no, there are no new developments regarding arm reduction surgery. Basically eight things can be done to the arm after weight loss: traditional liposuction, VASER high definition liposuction, a crescent arm lift, modified longitudinal arm lift, modified T arm lift, longitudinal brachioplasty with the incision in the bicipital groove (between the biceps and triceps), longitudinal brachioplasty with an incision on the back of the arm from the armpit to the elbow (in the triceps region), and the complete bracioplasty with an incision from the armpit to the elbow and to the lateral or ulnar side of the wrist. Since you have lost a significant amount of weight and “cannot cope” with the longer armlift scar, most experienced plastic surgeons would suggest you investigate VASER Hi-Definition liposuction. During this procedure, aggressive liposuction is performed to sculpt the deltoid, biceps, and triceps muscles. This leads to a more muscular arm, but it works very well for patients who have lost significant weight and do not want the arm-lift incision. Therefore, in conclusion, your best arm results will be achieved with a longitudinal brachioplasty, with an incision from the armpit to the elbow. However, since you “can’t deal with the arm lift scar”, the second-best choice would be VASER Hi-Definition arm liposculpture. I hope this information helps. Good luck. I hope I have answered your questions regarding the arm reduction, including any promising new techniques for arm lifts. If you have any more questions regarding the arm lift, arm reduction, brachioplasty, arm scar revision, 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 150 arm lift procedures. Make sure they have the before-and-after pictures to prove it. Carefully examine their before-and-after ictures 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.)

Gerald Minniti, MD, FACS · Answer

Hello,You are correct, you can't fool mother nature, and too much excess skin can only be removed down the length of the arm, leaving a long scar.  Placement of the scar is crucial to minimize visibility.  Post operative tape/silicone sheeting therapy for at least 3 to 6 months is also important to minimize scar visibility. There is no non-surgical or minimally invasive, hi-tech device that can dispose of the amount of skin that is typically taken during an arm lift. Go on a few consults with surgeons expert in body contouring. Best of luck!

Justin Yovino, MD, FACS · Answer

Unfortunately there are not any good substitutes to the traditional brachioplasty other than liposculpture.

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.  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.  Immediately after the operation compressive Ace wraps are placed from the fingers up to the armpit.  These can normally be removed within 24-48 hours postoperatively.  Elastic compression sleeves commonly worn by athletes can be purchased relatively inexpensively at any sporting good store.  Many patients wear these for up for up to 2 weeks postoperatively.  No vigorous activity or strenuous activity is recommended for 3 weeks postoperatively.  Complications following a well planned and well executed brachioplasty are uncommon.  They may include however wound infection or wound breakdown.  Is very important to follow the directions of your surgeon postoperatively to ensure the best years improvements have been made in the performance of brachioplasty (arm lift) leaving better scars than had been achieved in the past.  This includes more precise incision placement, better closure techniques and use of post operative scar reducing systems.  With greater attention to these details the benefits of arm lift surgery can be achieved with more acceptable scarring than in the past.

Brian P. Tierney, MD · Answer

Yes there are alternatives to the traditional arm lift. You are correct that most patients do not want a large long scar visible on the arm. Thermi Tight is an excellent choice to improve the contour of the arm.  It is a minimally invasive procedure performed in the office under local anesthesia. You need just one treatment. The results are excellent. I have perform this procedure many times in the office.  Always consult with a board-certified plastic surgeon

Ronald V. DeMars, MD (Retired) · Answer

The full brachioplasty is till the "gold standard", and the thin white line scar is the trade off for the youthful contour. I find it hard to believe any good surgeon would have let you spend money on liposuction with your weight loss history. When positioned properly down the inside of the arm the scar is not visible with almost all natural arm positioning. When positioned down the back of the arm as some inexperienced surgeons will do, the scar is invisible to the patient but highly visible to everyone else. Choose your doctor carefully.

Any promising new techniques for arm lifts?

Answers (7)

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