Arm Lift / Scarring. Would I get the full benefits with an under arm incision? (Photo)

Question

I'm going abroad soon for arm lift surgery. I originally wanted just liposuction but was told that due to skin laxity I could get better results with an arm lift. But because of my skin tone I am scared of scarring, but the surgeon said that he could make an incision under my arms so from the pictures would I get the full benefits of an arm lift with an underarm incision, if not what is scarring like on black skin as I do not want a scar going down my arm and afraid of keloids. Thanks

Lisa J. Peters, MD · Answer

I understand your concern regarding an incision from armpit to elbow, but unfortunately I believe that is the trade-off for making an improvement in the contour of your upper arm.  Your photos show loose upper arm skin, which will only be worsened with liposuction.  A limited incision approach to an arm lift may only make a subtle improvement in the contour of the upper arm near the armpit.Scars associated with an arm lift do tend to be less attractive than scars elsewhere.  Though some patients heal with beautiful, thin, inconspicuous scars, other patients develop wide, raised, or thickened scars in patchy areas or along the whole length of the scar.  I  advise the use of topical silicone after surgery (sheets or gels such as Kelocote) to optimize a patient's chance of achieving a good scar (talk to your surgeon about their recommendations first before using any product).Your goal photo does indeed have a beautiful arm, though probably not achievable for most women.As other surgeons have mentioned, I strongly advise against going abroad for cosmetic surgery.  Though foreign locations may offer attractive pricing, it is not worth the increased risk of complications of surgery as well as the issues associated with taking care of complications that could arise once you are back home.  This could result in a substantial increased expense making your ultimate out-of-pocket cost much higher than if you'd just found a qualified surgeon in your area.

J. Timothy Katzen, MD, FACS · Answer

Hi Channy687 in New London, CT, thank you for your question regarding arm lift / scarring, and would you get the full benefits with an underarm incision? Thank you for your history and your pictures. First, we should analyze your pictures to determine the best arm procedures. You have moderate lipodystrophy (excess fat) from the axillae (armpit) to the elbow. Also, you have moderate cutis pleonasmus (excess skin) and dermatocholosis (loose skin) from the axillae (armpit) to the elbow. Based on these pictures, you have a Type 3 arm with excess skin and fat from the armpit to the elbow. You would do best with a longitudinal brachioplasty from the armpit to the elbow. Arm liposuction is usually included. Any surgery shorter than a longitudinal brachioplasty will yield sub-optimal arm reduction results. If you cannot “manage” the longitudinal arm scar, you must be willing to accept less-than-ideal arm lift results. This is the law of diminishing surgical returns. The more surgery you do, the better your surgical results. The less surgery you do, the less your surgical results will be. To the final point, where if you do not have surgery, nothing is accomplished. Most experienced plastic surgeons who are arm-lift experts very rarely have patients who develop keloids after arm lifts. Usually, the armlift scar heals very well. The keys to avoiding an armlift scar are keeping tension off the incision line, using absorbable sutures, wearing a compression garment for at least 6 weeks, and applying silicone cream and strips for at least 6 months after your brachioplasty. Based on your pictures, most plastic surgeons would not recommend isolated arm liposuction for your arm treatment. Also, most experienced arm lift experts would not recommend the limited incision, crescent, mini, or T incision arm reduction. You will not get much benefit from these limited procedures. If you choose these limited arm-lift incisions, you will likely be disappointed and need an arm-lift revision. I hope I have answered your questions regarding the arm reduction, specifically your question about arm lift/ scarring and whether you would get the full benefits with an underarm incision. 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 photos and review their RealSelf profile. 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.)

Francis Johns, MD · Answer

Thank you for your question.The scarring from a Brachioplasty can be unpredictable. Some patients heal very well and have a tiny thin line that heals nicely, others develop slightly widened scars that stay red/pink and do not fade. As you know being African American does increase your risk of developing keloids, so I would definitely put some thought in to this before making any decisions. Good luck.

John J. Edney, MD · Answer

Judging by your photographs it appears that he would need a full brachioplasty in order to achieve the full benefits.  A limited procedure and your case will result in a limited outcome.Many patients are understandably concerned with the potential of a less than ideal scar resulting from a brachioplasty.  Careful planning and placement of the incision, however, can often significantly improve the appearance of the postoperative scar.  For that reason it would be best to consult a surgeon certified by the American Board of Plastic Surgery who performs brachioplasty on a regular basis in order to have the best opportunity for an optimal outcome.  Good luck.

Zachary Farris, MD, FACS · Answer

Thank you for your question.  Since the extent of your skin and fat excess extends across your entire arm, a limited incision arm lift would leave you with a poor result.  I would caution you about going abroad for cosmetic surgery since surgery may not be as regulated and surgeons not as properly vetted as they are in the US.  They may offer a lower price but sometimes you get what you pay for.

Vasdev Rai, MD · Answer

You will not get results of your wish picture with any approach.  You should be concerned about scar.  Limited upper arm tuck is ineffective. You should accept your limiting factors and accept improvement that comes from liposuction.

Sonya Merriman, MD · Answer

Based on your picture, I don't think you would get a great result with a scar that is limited to the underarm area. My other concern is that you state you are going abroad for the surgery. Most patients who do this, do it because the procedure is less expensive when you go outside of the United States. There are a couple of traps in this situation. It is more difficult to check out the credentials of the surgeon abroad, and to check out the facility where the surgery is going to be done. Both of these are very important. The other is that if you do have complications, you would likely wind up paying a surgeon in the United States more to deal with the complications than you would to have the brachioplasty surgery done. If I were you, I would consult with a Plastic Surgeon in the US that is board certified by the American Board of Plastic Surgery and who is a member of the American Society of Plastic Surgeons.

Ronald V. DeMars, MD (Retired) · Answer

You have excess skin and fat the length of the upper arm. The best results will require liposuction and an incision from armpit to elbow. Anything less will be a waste of time and money.

Arm Lift / Scarring. Would I get the full benefits with an under arm incision? (Photo)

Answers (8)

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