I developed PAH after a non-invasive procedure. Do I need an Arm Lift or Is there a less invasive option? (Photos)

Sorry you had this complication, that's tough. I'd recommend trying liposuction plus bodytite. Mini arm lifts are garbage, dont do them. You'd get some good improvement with lipo and bodytite. It can be done awake in clinic for easier recovery. I'd probably also add vaser for the additional tightening and better fat removal. You COULD do it with a mommy makeover, but that's a lot of surgery and your surgeon would need some assistants to keep the operative time down, also found that scarring is worse with larger procedures, so I'd agree with avoiding that but it is doable. There's also a lesser known technique that uses a hemostatic net to aid in skin tightening after liposuction of the arms that works pretty well and you'd be a good candidate for.

Hello Exuberant872628, thank you for your question regarding what to do with your arms after you developed PAH after a non-invasive procedure, and whether you need an arm lift or if there is any less invasive option. Thank you for your history and your pictures. PAH is paradoxical adipose hyperplasia. This is a rare but known possible complication of CoolSculpting procedures.
In analyzing your pictures, you have excess skin and fat from the axilla or armpit to the elbow. You have cutis pleonasmus (excess skin) and dermatocholosis (loose skin) without stretch marks (striae). That means you have a Type 4 arm. The best treatment would be an extended brachioplasty (arm reduction with arm lift) combined with arm liposuction. That would mean you would have arm liposuction and an incision from the axilla to the elbow. The incision is placed between the biceps and the triceps. This would give your best results. Because of your children, most plastic surgeons would suggest doing the brachioplasty in isolation without any other procedures. Renuvion and Body Tite will not significantly improve your arms. Renuvion and Body Tite may tighten your arm skin slightly, but they will not remove arm fat. Additionally, if there is scar tissue left from the PAH, Renuvion and Body Tite will struggle to dissolve the scar. A mini arm lift is not indicated and would not improve your arms. A mini arm lift is reserved for Type 2 arm patients to have excess arm skin and fat in the proximal third of their upper arm, near the armpit. Plan on a two-week recovery for the extended brachioplasty. Good luck. I hope I answered your questions regarding what to do with your arms after developing PAH following a non-invasive procedure, and whether you need an arm lift or if there is a less invasive option. Since a brachioplasty or arm lift surgery is a difficult procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing these types of arm lifts. Do your research. Make sure your chosen plastic surgeon has performed at least 150 arm lifts. Make sure they have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. Sincerely, Dr. Katzen, MD, MBA. (Plastic Surgeon, President of the American Society of Bariatric 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, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

An in person evaluation is best, but based on the photos it appears the skin laxity is too severe to achieve great results from the more minimal approaches. A standard arm lift would be able to address the excess fat, remove redundant skin, and recontour the arms. You could consider the other options if you are accepting that you wouldn't likely get optimal results.

Most of your excess skin seems to be in the middle and distal third. It may be possible to use a shorter incision but I do not think a transverse axillary lift would be adequate. When I do axillary lifts I combine it with liposuction at the same time. If you are willing to accept a less than perfect result then you can consider liposuction and then a transverse axillary lift.

Best Wishes,

Gary Horndeski, M.D.