200lbs & on semaglutide, arm lift or lipo vaser? (Photo)

Question

I have reached out to multiple doctors and have gotten mixed recommendations between an arm lift and Lipo. I weighed 250 pounds about 10 years ago and lost about 100 pounds and got a tummy tuck in 2017. I have gained about 50 pounds since then I am about 200 pounds at the moment but I am on semaglutide.

J. Timothy Katzen, MD, FACS · Answer

Hello Newskin2019. Thank you for your question regarding whether you should choose an arm lift or VASER liposuction.

After examining your photos, I believe you would be an excellent candidate for an arm lift. While VASER liposuction would effectively remove fat from your arms, it wouldn't help your skin contract significantly. Given your history of weight loss and the current state of your skin, liposuction alone would likely leave you with loose, sagging skin. An arm lift, on the other hand, would remove both the excess skin and fat, giving you the tighter, more contoured arms you desire.

I hope this helps you in making your decision. Best of luck with your continued journey!

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

John Reilly, MD, FACS · Answer

Hello,

First we  have to decide on a diagnosis. Is it extra skin, extra fat or both? It may be both.  An arm lift is the most reliable way to take care of the loose skin portion. It does have a significant visible scar as a trade-off. Sometimes Plan B can be effective. Depending on how the skin feels and how it looks on the outside of the arm, liposuction can be considered knowing it is not the best treatment for the loose skin, but some people will have a very generous amount of skin retraction after liposuction. This differs from patient to patient but you might get enough to be satisfied without a significant scar. You can have an arm lift after liposuction if you are not completely satisfied. In my opinion, adding laser lipo to the equation does not provide reliable Improvement in skin contraction considering the increased cost for such a device. Good luck.

Joel Patrick Maier, MD · Answer

A brachioplasty will help with your skin. Liposuction alone will shrink the skin to a much smaller size of ptosis, but you will want the skin taken care of since it looks like a majority of the rejuvenation at this point. Thank you.

Chet Mays, MD · Answer

Thank you for your inquiry and congrats on your weight loss! You are a great candidate for a Brachioplasty procedure as that will remove excess skin to your arms. Liposuction to both arms can also be done in the same procedure. I recommend consulting with a board certified plastic surgeon like myself to create a surgical plan for you targeted towards your specific goals.

James M. Economides, MD, FACS · Answer

Given your weight history, including significant weight loss and your current use of semaglutide, your mixed recommendations between an arm lift and liposuction make sense. Here’s a more personalized breakdown based on your situation:

1. Arm Lift (Brachioplasty):
Why It Might Be Recommended: Since you’ve experienced significant weight loss, skin elasticity in the upper arms may be compromised. After losing 100 pounds, it’s common to have loose, sagging skin that might not respond well to liposuction alone. If you have skin laxity, an arm lift would be a better option to address both excess skin and fat. This will give you a smoother, tighter contour.
Benefits: Removes excess skin and fat, resulting in a more toned appearance. This is especially important if the skin in your arms is sagging post-weight loss.
Consideration: The trade-off with an arm lift is the scar along the inner arm, though this can fade over time.
2. Liposuction:
Why It Might Be Recommended: If your skin still has some elasticity and the primary concern is fat accumulation (due to weight gain), liposuction may help sculpt the arms. However, since you’ve gained some weight after your tummy tuck and are currently on semaglutide, it’s important to consider how your skin will respond to future weight loss. If your skin can’t retract after fat removal, you may still end up with sagging skin, even after lipo.
Benefits: Less invasive, shorter recovery time, and if you still have good skin elasticity, it can provide great results.
Consideration: If there’s loose skin after weight loss, liposuction may not provide the tightening you’re hoping for, and you might later require an arm lift.
Considering Semaglutide:
Weight Loss on Semaglutide: Since you’re on semaglutide, which is helping with weight loss, your arm appearance may change further as you lose weight. This means you might want to wait until your weight stabilizes before undergoing any procedure to ensure the most effective long-term results.
Recommendation:
If you’re still losing weight, I recommend discussing with your doctor about waiting until your weight stabilizes before deciding between an arm lift or liposuction. An arm lift may ultimately provide the most comprehensive result if skin laxity is a concern, but if your skin still has good elasticity, liposuction could be sufficient.
Ultimately, the right decision depends on your skin condition and future weight loss goals. A consultation with a surgeon who has experience in post-weight loss body contouring would be helpful to finalize the best approach for your arms.

Joe Gryskiewicz, MD, FACS · Answer

Hello, an arm lift is going to remove the lose skin for a slimmer less hanging arm look. The liposuction is only going to remove the fat from the area. From the sounds of it you have lost some significant weight which means there is likely some loose skin. If the skin hanging is the biggest concern I would look at doing the arm lift.

Jeffrey M. Darrow, MD · Answer

Thank you for your photo. Congratulations on your weight loss. To achieve the best result, you would  require liposuction of portions of your arm, and then after the circumference of the arm has been decreased, skin resection would be required to remove redundant skin as your skin is not likely to contract and tighten using only  Vaser liposuction.  Your trade-off would be an incision along the lower 1/3 of your arm, but your benefit would be the very best arm contour that you could achieve. Have a detailed discussion with your plastic surgeon. Best wishes.

Ryan Rebowe, MD · Answer

The way to get the absolute best contour will be an arm lift. However, this will come at the cost of a relatively long scar that may extend into your armpit. There are more moderately invasive procedures, such as BodyTite, that will have smaller scars but less of an effect. Most of the time following significant weight loss an arm lift is necessary to appropriately tighten the skin, but it all depends on patient preference and expectations.

Arif Eroglu, MD · Answer

Hello; If you do not have very wide stretch marks on your skin and do not expect for very tight arms, I recommend for Vaserlipo to remove fat from your arms and Renuvion J Plasma technique for skin tightening as well.

Gary M. Horndeski, MD · Answer

Vaser lipo will not contract the skin enough. You will need a brachioplasty. At the time of brachioplasty, liposuction is also done to remove the fat to make the dissection easier. Semaglutide will not interfere with the healing process of your results.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

200lbs & on semaglutide, arm lift or lipo vaser? (Photo)

Answers (18)

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