Laser Lipo or Arm Lift for Upper Arm "Bat Wings" (photo)

Question

I’m in my 20s and considering VASER liposuction for my upper arms to address “bat wings.” My skin has good elasticity and bounces back when pinched, so I hope to avoid an arm lift due to scarring and invasiveness. Is it realistic to achieve smooth, contoured arms with VASER lipo alone, or is an arm lift typically necessary for cases like mine? Your professional insights would be greatly appreciated. Thank you!

J. Timothy Katzen, MD, FACS · Answer

Hi PMI9697, Thank you for your question regarding whether you need laser lipo or an arm lift for the upper arm "Bat Wings."  Thank you for your history and your pictures.  First, we should analyze your pictures to determine the best procedures. From your pictures, you have upper arm cutis pleonasmus (excess skin) and dermatocholosis (loose skin) without stretch marks (stria).  Also, You have Class 3 arms. That means you have excess skin and fat from the elbows to the armpit. Your best surgery would be a longitudinal brachioplasty. During a longitudinal brachioplasty, upper arm liposuction is performed. This will de-bulk the upper arm of a majority of the fat. Then, an incision is made from the armpit to the elbow. A large elliptical area of upper arm skin and fat is then removed. The eventual scar is between the biceps and the triceps. This is the best position for the arm lift or arm reduction scar. By placing the incision between the biceps and the triceps, the brachioplasty scar is hidden by your arms when you naturally hold your arms by your sides. Since you have excess arm skin, your arm skin will not bounce back, even if you use laser lipo, VASER lipo, or radiofrequency. Because you have a significant amount of arm skin, liposuction procedures alone are not optimal for your arms. You need a full longitudinal brachioplasty. I would not waste your money or time having arm liposuction. You need an arm lift. I hope this helps to answer your question regarding laser lipo or arm lift for your upper arm "bat wings."  
Since a brachioplasty or arm lift surgery is difficult, 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.)

Jonghyun Hong, MD · Answer

Hello,
This is Dr. Hong from Fresh Clinic, Seoul, South Korea.
Whether we use Vaser or traditional liposuction, the outcome largely depends on the skill and experience of the surgeon. I practice both techniques, using Vaser for larger areas and traditional liposuction with nano cannulas for more delicate regions.
However, it’s important to note that while Vaser or AccuSculpt may provide some degree of skin tightening, we cannot guarantee complete skin retraction, and some mild skin laxity may remain. To minimize sagging, I strongly recommend wearing a compression garment for three months, with resizing every three weeks or month, as needed.
Regarding an arm lift, it is a relatively straightforward procedure and can be performed after you have fully recovered from liposuction, if it is still something you wish to pursue.
Hope my answer will help you ^^ Best Regards

George Marosan, MD · Answer

Thank you for your question and photo. Based on this photo, I would recommend VASER liposuction (not Laser lipo). You will need Renuvion skin tightening at the same time. I would not recommend an arm lift at your age. As a Total Definer plastic surgeon, I would do the VASER and the Renuvion. This is approached through 1cm poke holes in the arm pit front and back and one behind the elbow. These will leave no signs that surgery was performed. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Harry T. Haramis, MD, FACS · Answer

In my experience, Vaser ultrasound (or laser) liposuction usually gives excellent results for arms without removing skin.

Sometimes, as skin tightening cannot be guaranteed, arms improve tremendously but a small amount of laxity may remain. Most patients prefer this to long arm lift scars. In a very small percentage of those, a smaller arm lift month’s later is an option- (typically these have very last skin, stretch marks, etc from a massive weight loss),

You appear to be a good candidate for Vaser.

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.

Mats Hagstrom, MD (license on probation) · Answer

Correct procedure we need to first have a clear understanding of what the problem is.
Liposuction only removes subcutaneous fat while an arm lift generally only removes excess skin.
To decide between the two procedures you need to first have a good understanding if the problem is more related to skin or more related to SF.
 You also need to take into consideration the impact of each procedure.
If you judge the outcomes with your arms stretched out like in the picture you’ve included you’ll probably be unhappy with what Liposuction can achieve.
If you have an arm lift you likewise, maybe quite unhappy with a highly visible scar.
 If you judge the outcomes with your arms in a down position, you could potentially be quite pleased with what quality Liposuction can deliver if done correctly.
Liposuction is technically challenging and can easily leave to pour outcomes with contour irregularities that may be irreversible if done incorrectly.
 Having a higher energy device like VAS ER serves no advantage other than making the procedure faster for the surgeon.
Arms do not require aggressive equipment.
If anything arms should be treated carefully and delicately using smaller cannula without the need for pre-treatment using ultrasound or other devices.
Provider selection is by the most variable .
 Finding the right plastic surgeon is not at all easier straightforward.
You might find it that plastic surgeons were not particularly good at Liposuction may steer you towards an arm lift, and those who are proponents of liposuction may recommend against an arm lift.
I recommend bringing pictures of yourself to use as a reference during consultations.
Include pictures of your arms in an outstretched position like what’s included and pictures of your arm straight down.
you can look at some of my before and after pictures under my profile patient who had arm liposuction to get an idea of what liposuction results can look like. Paragraph I believe I’ve included some pictures who also had skin laxity.
Considering Liposuction providers to as many before and after pictures as possible.
Seeing one or two examples is insufficient and you should also ask them to show you pictures of previous patients look just like you do.
If they have sufficient experience, then there should be no lack of before and after pictures.
I think, insisting on seeing at least 10 examples of previous patients who had similar arm characteristics to your own is reasonable.
Finding the right plastic surgeon is most likely going to require having multiple consultations.
If you don’t go through the selection process carefully and formally your chance of quality outcome it goes down significantly.
Neither an arm lift nor arm. Liposuction are easy, straightforward procedures in my opinion.
This can easily turn into something that leaves you with regret if your provider selection isn’t done carefully.
There’s no right or wrong answer in regards to an arm lift versus Liposuction.
It depends on what you’re trying to achieve and what you’re willing to go through.
You should have a clear understanding of what each procedure can and cannot accomplish.
Most plastic surgeons are not going to do real liposuction in conjunction with an arm lift.
That means if you have a substantial layer of subcutaneous fat, you’re still going to have that after an arm lift only the skin will be pulled tighter.
How the procedures are done is going to vary between each provider and there may be some who do a certain amount of liposuction in conjunction with an arm lift.
You’ll need to ask each provider during consultations.
Recognize that the decision making and the entirety of this process is fairly complex.
Don’t rush into decisions that are going to affect your outcome for the rest of your life.
When in doubt, slow down and schedule more consultations.
Best,
Mats Hagstrom MD

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