Cut off or work off? (Photo)

In a perfect world I would like to be able to fix my saggy upper arms with working out. however I am in fear that I have too much skin and need what I see is Brachioplasty? My upper arms are extremely loose and flabby. I've lost weight but only like 40 pounds. Looking from my pictures are my arms too dramatic for muscle training, so I would have to get this problem surgically removed? please help me I have no idea what to do.

Doctor Answers 14


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I do not think the scar from the arm lift would be worth it for you.  There are different types of tightening machines out there such as E-Matrix,  6 treatments of that coupled with exerciese may give you the results you are wanting.  

Provo Plastic Surgeon

Options for skin on arms

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You seem to be a good candidate for ThermiTight. It is a radio frequncy tightening device that is placed under the skin and helps to shrink the skin. It is done under local anesthesia and there is a little swelling for a few days. Results are achieved slowly over a few months. No long scars as all that is needed are small stab wounds for the needle/cannula.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Sagging arms can be improved with working out

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The picture you've submitted does not really allow me to decipher if your skin has good elasticity. Working out will definaty help but ultimately you alone will need to decide if that is enough. I don't think you will require a surgical skin resection (Brachioplasty) but it will depend on your expectations. Laser liposuction may be the answer once you feel you have developed your arm muscles. It is a minimally invasive procedure that removes fat and tightens skin. Good luck

Laurie A. Casas, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 108 reviews

I say -- no surgery!

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you do have loose skin, but right now, we do not have a really good way to help you-- the external devices are OK-- a little result-- but not what you really want,. The problem is that surgery is too extreme and the external  devices are too subtle-- but I would continue to work out, and be happy with your overall fitness level improving.
Warm Regards.

Anne Taylor, MD
Columbus Plastic Surgeon
4.9 out of 5 stars 49 reviews

Cut off or work off?

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You have several options in my opinion that can be addressed from least invasive to most invasive.  

1.  Try to work it off with a combination of cardio and weight training...What do you have to lose?  If that doesn't work you can always try surgery.
2.  Liposuction.  There are options such as SMART lipo that use laser assisted liposuction to firm and tighten the skin.  Though there are limitations, based solely on the photo, you might be a candidate especially if the doctor is well versed in this type of procedure.  I find in my practice that the laser allows the most dramatic results with the neck and arms.
3.  Brachioplasty.  I would use this as a last resort for someone like you with only minimal laxity.

See a board certified plastic surgeon or two and let them help you decide.  Best wishes and take care.

Shayne Webb, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 48 reviews

Lost Weight, Now How to Fix These Arms?

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Consult with a board-certified plastic surgeon who does brachioplasty surgery as well as minimally and noninvasive tightening procedures so you can learn about all your options. 

Heating tissues with radio frequency, ultrasound, or laser energy can tighten skin and is often combined with liposuction. Whether you would be a good candidate for one of these modalities would require a physical examination.

Of course, surgery would result in less loose skin but would leave a scar. 

Click on the link below to see the results of arm tightening after SmartLipo.

Good luck! 

Heather J. Furnas, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 33 reviews

Cut off or work off?

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It always pays to get into as good muscle tone as possible, however, even with the best of muscle tone you may still have some unwanted skin excess.  Energy assisted procedures such as Vaser ultrasound and ThermiTight radio frequency can help to some extent.  For maximum tightening, a surgical brachioplasty, in which the excess skin is resected, would be necessary.  Best wishes, Dr. Lepore.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.8 out of 5 stars 59 reviews

Congratulations on losing 40 lbs! Saggy upper arms can be addressed with lipo

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Congratulations on losing 40 lbs!! If you lost the weight rapidly, your skin may not have had enough time to catch up.  I generally recommend waiting 6 months to allow skin to contract.   If you are young, have dark skin, no stretch marks on the arms and are at least 6 months out from the weight loss then I usually recommend liposuction to the arms with a wedge excision hidden In the axilla ( arm pit ). The liposuction lays down strands of collagen which contract and tighten the skin while removing any residual or stubborn fat. The incision (scar) in the armpit hides very well.  I recommend keeping the elbows as close to your side as possible during the following 6 weeks to minimize any widening of the scar and wearing a compression garment to prevent swelling of the arms so they can become as small and tight as they possible can! I do WAL ( Water Assisted Liposuction) as an office procedure with the Body Jet!  The recovery is quicker and with minimal bruising and most importantly.... My patients love the results !!

  Good luck!!
  Deirdre Rhoad, MD
- Board certified by the American Board of Medical Specialties- Plastic Surgery

Deirdre M. Rhoad, MD
Austin Plastic Surgeon

Excision or Exercise

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While exercise has a role in both weight loss and muscle tone, there is no role in correction of aging or sagging skin without a surgical intervention. This is very common, especially among patients who have lost weight.

The most important thing to consider when contemplating brachioplasty is the scarring which can be significant. 

As always, discuss your concerns with a board certified plastic surgeon.

Donovan Rosas, MD
Kissimmee Plastic Surgeon
5.0 out of 5 stars 12 reviews

Can I work off fat in the upper arms?

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Thanks for your question. It brings up two misconceptions. Patients often think that they can work the fat off a local area such as the upper arms by exercising the upper arms specifically. The body does not think that way! If you burn calories by exercising the upper arms, calories are burned first from the glucose in the liver and secondarily from fat all over the body. Eventually, when the fat burning has progressed to an advanced stage, you will notice it in the arms as well as everywhere else.
The second misconception is that you can 'tone up' loose skin by exercise. You can't! I suppose that if you bulk up the muscles to an advanced degree, there will be less loose skin, but few women would like to be quite this muscular.
So, if the skin is already loose, you should consider a brachioplasty. The scar is long but is tolerated well. An EXPERIENCED Board Certified Plastic Surgeon is the person to see because any misjudgement in the amount of skin excised can produce a severe contour deformity that is difficult to fix.

J. Brian Boyd, MD
Rolling Hills Estates Plastic Surgeon
5.0 out of 5 stars 5 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.