Why don't more surgeons offer scarless arm lifts?

The small-incision or minimal-incision arm lift, often performed with an incision in the armpit, can provide excellent results for certain patients, but it’s not always applicable to everyone. Here’s why most plastic surgeons still use the longer incision technique:

1. Extent of Skin Laxity:
The minimal-incision arm lift, where the incision is hidden in the armpit, works best for patients with mild to moderate skin laxity in the upper arms. If the skin laxity is more significant, especially after major weight loss (as in your case), the armpit incision alone typically won’t provide enough access to remove all the excess skin.
For patients with moderate to severe skin laxity, the longer incision along the inner arm allows surgeons to remove more excess skin, achieving a tighter, more comprehensive result.
2. Limitations of the Armpit Incision:
Reduced Access: The small armpit incision gives limited access to the full length of the upper arm. In patients with significant sagging or loose skin that extends beyond the upper arm, it becomes challenging to adequately address the full length of excess tissue through a small incision.
Skin Retraction: Even if some skin tightening can be achieved with liposuction or non-invasive treatments, the skin’s ability to retract fully is limited. Patients with more significant sagging after weight loss often need a full removal of excess skin, which requires a longer incision for optimal results.
3. Aesthetic Results:
While the armpit incision is more hidden and less noticeable, if the skin is too loose, using a smaller incision can lead to suboptimal results, including uneven skin tightening or skin folds. The goal of plastic surgery is to provide the most natural and smooth contour, and in cases of significant excess skin, a longer incision is necessary to achieve this.
4. Why Some Surgeons Don’t Adopt the Armpit Technique:
Many plastic surgeons prioritize achieving the best contour over minimizing scarring, especially when dealing with larger amounts of skin. Since the longer incision often gives the most comprehensive results for patients with more significant skin laxity, many surgeons continue to use this technique.
Scarring Techniques: Surgeons have become adept at minimizing and camouflaging scars from longer incisions, using techniques to ensure that scars fade over time or remain as discreet as possible.
Final Thoughts:
The small-incision arm lift is an excellent option for patients with mild to moderate skin laxity, but it’s not always appropriate for those with more significant excess skin after weight loss. The longer incision provides better results in cases where there is extensive sagging. It’s important to consult with your surgeon to determine which method will give you the most satisfying, long-term results based on your unique anatomy.

Thank you for your inquiry! There are different levels of skin laxity and every doctor has their own technique that is catered to the individual patient for the best obtainable results. Schedule a consult with a Board-Certified Plastic Surgeon to help you reach your personal goals.