Am I a good candidate for an arm lift revision? (Photos)

Hello, and thank you for your question regarding whether you’re a good candidate for an arm lift revision. Thank you for your history in your pictures. I’m sorry you have developed issues with your arm. It appears that you are doing the right modalities to stimulate the nerve, including massage, lymphatic drainage, and acupuncture. Since you are nine months after the surgery, you are still healing. However, you may have to realize that you may have permanent numbness in this area after your arm lift. This probably will not improve after your arm lift, but may improve independently. Most plastic surgeons would suggest you wait another three months. That means you will be approximately one year after your initial brachioplasty. At that time, I would suggest an arm lift revision. I would suggest that your plastic surgeon perform aggressive arm liposuction in addition to removing more excess arm skin. Arm liposuction will remove excess arm fat and help to break up scar tissue. You have issues with the skin and fat of the left arm that is left over from a prior surgery. Surgery will most likely improve the appearance, shape, and form of the arms. There is the baseline risk of further nerve damage, but again, it is relatively low. In addition, you have numbness in the left arm from a prior surgery. The numbness may not change, and revision surgery may not help with the nerve issue, but arm revision surgery will help to remove more arm skin and fat. The placement of the arm scar appears to be correct; however, there appears to be more excess arm skin and fat that needs to be removed. Most plastic surgeons would suggest that the incision be continued around the elbow. Your arm incision should extend down the upper arm and then make a 90° return and go behind the elbow. This will get rid of some of the “dog ears,” excess arm skin, and fat that you have on the posterior of your arms when your elbows are extended. I hope this helps to clarify what to do with your arms, nine months out from a brachioplasty, and the fact that you have numbness in the left arm. 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, MD, MBA. (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.)

Based off your photos - (without an examine) I agree, more skin can be removed based off your current 9 month photo. The question is will the numbness come back as you get closer to the 1 year and more mark or will it stay about the same (difficult to assess - if there's no nerve issues - this can still be transient and still recovering; if there is nerve issues - scar tissue trapping it, maybe technical issues - then the chances of sensation coming back will be much less) - If the extra skin bothers you enough, I would recommend discussing with your surgeon the differences if you should pursue revision and seeing what can be done in terms of the sensation. If you're already numb and its manageable - usually removing more skin likely won't decrease any more sensation than you have already lost (sometimes if there's nerve trapped under scar tissue - this actually might help with rebuilding sensation back if the scar tissue is removed or excised) In the meantime, I recommend lifting weights to help build more muscle to your arms to help fill out the loose skin some more and still compress and massage daily (self message). This is a tough decision that you need to think and weigh the benefits / risks with by also discussing with your surgeon for this next revision procedure.

Thank you for your query! A revision of your arm lift will be beneficial based on your photographs. Damage to nerves can be avoided with a careful skin only excision. Please discuss all your concerns with your surgeon who can examine you and help you make a decision. All the best!

Thank you for your inquiry! We would love to meet with you to discuss your concerns with your brachioplasty results. Schedule a consultation with a Board-Certified Plastic to discuss your goals.

Hi, according to your pictures, seems like you still have excess skin on your arms. Second surgery, naturally, will have slightly higher complications risk, but it doesn’t mean that you are going to have one. You can think of this like a trade. If you want better looking arms you should take slightly higher risk. You are the one who decides if it’s worth. In my professional opinion second surgery will work for you.

Unfortunately, you still have an excess of skin that was left behind after your last surgery. Given the degree of error, I recommend finding another surgeon in your area.

Thank you for your photos. Your arm contour is improved, but could be improved more with a revision of your arm lift. This would likely require some liposuction on the posterior aspect of your arms to decrease the volume and then a revision of your skin excision to remove excess skin. With any surgery, there is always the possibility of nerve injury, being temporary or permanent, so you would have to weigh this possibility against the option of a better arm contour. As the revision arm lift would remove your present scar, with a meticulous closure done your new incision line should look the same.

Clearly you still have excess skin. I would recommend a revision. When I perform a brachioplasty, I use liposuction first. The liposuction removes the fat but also dissects in such a way that the nerves are spared. It may be possible to do liposuction with the revision and may help prevent further nerve injury.

Best Wishes,

Gary Horndeski, M.D.

From the submitted photos you would benefit from further skin removal. This would improve the contour and make your arms more harmonious with your frame. There is risk to every surgery. I encourage you to discuss your concerns with your surgeon to determine what is best for you.

I would suggest go ahead with the revision and get more skin removed. Your surgeon has agreed, so now is the time to do this.