Should I consider a brachioplasty after 45 lb weight loss?? (photos)

Hello! I am 23 years old and over the past two years, I have lost about 45 pounds. I have found that the skin on my arms have been sagging to the point where I feel uncomfortable showing them. I have tried lifting weights and my arms still sag. The skin in that area seems to be much thinner. Do you believe I would benefit from a brachioplasty,mini arm lift or liposuction to the upper arm area? Thank you for your time!

Doctor Answers 14

Arm lift

A brachioplasty is essentially an upper arm lift. In this procedure, the excess hanging skin and fat in the upper arm is removed. Its the procedure used to correct the common "bat wing" of skin that manifests in patients who have lost a significant amount of weight.  A physical exam is really needed to make any recommendations. Best wishes.
Dr. Basu
Houston, TX

Surgical options

The best choice of procedure will depend upon your surgical goals.  It sounds like your main concern is the saggy skin.  In that case an arm lift is the best option because it removes excess skin, leaving a more contoured, tighter appearance.  It does have an incision line though that you must be comfortable with.  Liposuction will remove excess fat from the area, and may tighten the skin to some degree depending on the elasticity of the skin in that area.  It sounds though from the way you describe it that you may not get much tightening since the skin sounds thin.
Truly your best choice is to visit with a Board Certified Plastic Surgeon who can evaluate your current condition, discuss your goals and recommend the procedure that would be right for you.  Best wishes.

Camille Cash, MD
Houston Plastic Surgeon
5.0 out of 5 stars 28 reviews

Considering Brachioplasty

Thank you for your question about an arm lift (brachioplasty). Due to the excess of skin I will consider a Brachioplasty this will reduce the size and give you tighter arms. These are options to consider and discuss with a Board Certified Plastic Surgeon.

The timing of an Arm Lift (brachioplasty) after weight loss

An Arm Lift or Brachioplasty is a procedure that is commonly requested after significant weight loss, particularly in older patients who have lost a lot of weight. The issue is related to the very thin skin of the inner arm (much like the inner thigh) where the elasticity of the skin is less. When weight is lost, the thin skin does not "snap back" as well as areas where the skin is thicker, and the result is a loose upper arm (or inner thigh) with more wrinkles. Once your weight is stabilized to a new level, usually a year, and you are comfortable with that weight, a decision can be made about your arms. In a younger person the greater amount of elastic fibers in the skin can allow for a significant tightening of the arm skin for up to a year or two, and obviously bigger muscles do fill out the remaining skin to some degree. However, once you are at your goal weight for a year the likelihood of more improvement in your arm contour is minimal.

Douglas Leppink, MD
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 22 reviews

Arm Lift After Weight Loss

Patients who lose a significant amount of weight often have problems with extra skin.  The arms are no exception.  In many cases, the arm lift, or brachioplasty, is the best way to address this extra skin.  This should result in good contour of the arm, but it is a surgical procedure, which has risks and benefits.  I would recommend consultation with a board - certified Plastic Surgeon, who can review this with you and make a plan that is right for you. 

George Lawson III, MD, FACS
Winston Salem Plastic Surgeon
5.0 out of 5 stars 2 reviews

Should you get an arm lift?

Thanks for the question.  Without photos it is difficult to give you a faithful answer.  Certainly from your description, it sounds like you would benefit from the procedure.  These can be problematic areas.  Exercise and weight training won't address excess skin and as you lose more and more weight, the problem may seem to get worse.  That being said I would advise giving yourself time.  I like to see patients who've had a relatively stable weight for 6 months prior to proceeding.  This gives skin time to adjust to the new contour you've achieved through diet and exercise and also better defines how much if any work would be beneficial.  I would recommend you consult with a board certified plastic surgeon to have an examination and see if the procedure would be right for you.  Good luck!

Give it some time

Brachioplasty can leave a noticeable scar even in the most skilled of hands.  Especially living in the south were short sleeves and tank tops are common for a large part of the year.  Skin tightening always lags the weight loss.  I ask my folks to wait at least 6-9 after the weight loss to giveth skin time to tighten on it's own.  AT you age you shoals see significant tightening unless there are lots of stretch marks or damage to the skin.  If after waiting 6 months, I think a brachioplasty could be considered.

Paul Talbot, MD
Hattiesburg Plastic Surgeon
5.0 out of 5 stars 4 reviews

Brachioplasty or not

You should see a board-certified plastic surgeon to see what options are reasonable and what your expectations are. Often, one of the most significant concerns is whether you are willing to trade an improved arm contour for a scar which will likely be visible. After talking to your doctor, there may be an obvious choice that is best for you.

Ira H. Rex lll, MD
Fall River Plastic Surgeon
4.6 out of 5 stars 43 reviews

Options for arm contouring

It is hard to give you a recommendation without direct examination. If you do have hanging skin, brachioplasty (arm lift) will give you a good contour. However, it will have scar. Depending on your need, the scar can be elbow to armpit or confined around the armpit. If you have a mild laxity, liposuction/laser may help. It will be best to be examined by a board-certified plastic surgeon. Best wishes.

Options for upper arms after weight loss.

Congratulations on your weight loss. You are wise to ask the question now, as it appears you are at a crossroads in your diet/exercise/weight loss program. You have lost the weight, but you now don't want to show your arms, and further weight loss will only result in more "hanging skin."

BTW, you are correct in noting that weight training will not tighten skin. Even though you are young, your elasticity will only go so far in allowing post-weight loss contours to improve as fat volume is lost, and you would have to exercise like male body builders on steroids to enlarge your upper arm musculature enough to "fill" the loose skin.

All that being said, your youth allows the first step recommended for you to be ultrasonic liposuction. I have been doing ultrasonic liposuction for nearly two decades (and have had it myself) and do not find it "tightens" skin much on its own--that is up to whatever innate or residual elasticity you already possess. But it would still be my best recommendation for your first step--Vaser ultrasonic liposculpture.

If you don't like how well (or poorly) your skin contracts after liposuction contouring, then you still have the option for brachioplasty of one of the "mini" brachioplasty variations which exist. In general, I am not a fan of these since they try to accomplish much with too-little skin removal.

So, in order, I'd recommend continued weight loss and exercise to ideal weight FIRST, then ultrasonic liposuction/liposculpture, then if needed, skin removal via mini lift progressing to full brachioplasty. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 238 reviews

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.