37, arm sagging. Do I need liposuction or an armlift?

Question

I'm trying to ascertain wether the laxity in my upper arms could be improved with liposuction/liposculpture or if I would need a brachioplasty. I'm 37 now and my upper arms have always been disproportionatly large but they are sagging more as I get older

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Daniel Barrett, MD · Answer

Dear Natasha8794738,

it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jeffrey M. Darrow, MD · Answer

If your goals are simply to reduce the volume of your upper, posterior arms, then liposuction will do that with minimal scarring. No one‘s skin gets more elastic as they get older, so after the liposuction, the volume may be reduced, but you may still have some loose skin.  If that is acceptable to you, then liposuction would be a great option. If you are looking for skin contouring as well, then an arm lift would be required. The trade-off is that the skin of your arm would be contoured better, but you would have an incision along the inner aspect of your arm. A detailed discussion with your plastic surgeon would be very helpful. Best wishes.

Chet Mays, MD · Answer

Hi, Thank you for your injury. We would love to sit down and talk with you about your concerns. Schedule a appointment with a Board Certified Plastic Surgeon to help you reach your goals.

Zoran Potparic, MD · Answer

It is impossible to give you good advice without in person evaluation or at least teleconference. Skin tone, thickness and consistence of the underlying fat deposits are important components of decision making; liposuction/skin tightening or skin removal (with scar) are possible options. Good luck.

John LoMonaco, MD, FACS · Answer

Lipo with some form of skin tightening might reduce your size a bit, but the risk is that the thin and fragile arm skin is not smooth.  This has been a challenge for me over the years, and I perform llipo only on  on selected patients.  An arm lift IMO is the "gold standard" and will give you a "new" arm that is noticeable improved, but has a visible scar.

Camille Cash, MD · Answer

When deciding between the two procedures you have to consider the pros and cons of each.  An arm lift will not only address excess fat, but excess skin as well.  The result will be a more sculpted, thinner arm contour.  However it comes with the draw back of a more involved surgery and of course the scar.  Liposuction would remove excess fat and you can expect some improvement, but you may have some loose skin as a result.  You can also consider adding J Plasma which would tighten the skin somewhat.  I encourage you to begin by visiting with a board certified plastic surgeon near you for an evaluation.

Jaeil Lee, MD · Answer

From the images, it appears there may be a combination of factors contributing to the fullness and sagging in your upper arms. Some patients have excess fat in the upper arm even at a healthy weight, while others develop skin laxity from aging or weight changes and many have a mix of both.
Liposuction can improve contour when there is a meaningful layer of fat to remove. However, if the skin has limited elasticity, liposuction alone may not tighten the area enough. On the other hand, if most of the volume is fat and the skin quality is still good, liposuction can create a noticeable improvement without the need for an arm lift.
An arm lift (brachioplasty) is generally reserved for cases where:1. The skin folds or hangs when the arm is raised2. Pinchable fat is minimal3. The arm looks “deflated” rather than full
Your photos show some fullness, but only an in-person exam can determine how much is true fat vs. loose tissue. The right option depends on which factor is more dominant in your case.
A proper evaluation of skin recoil, fat thickness, and tissue quality will help determine whether liposuction, tightening, or a lift is the best fit for your goals.

Georgina Nichols, MD · Answer

Hi there! 
Thank you so much for your question and for sharing this here.
For upper arm contouring, it’s important to separate the fat component from the skin laxity. Liposuction is excellent for reducing excess fat, but it does not correct loose or sagging skin on its own. There are energy-based devices that can be combined with liposuction to help improve skin retraction, but results are limited when there is moderate to significant laxity.
If your goal is very tight arms then a brachioplasty (arm lift) may be necessary. This procedure directly removes extra skin, but it does come with a scar that typically extends from the axilla down toward the elbow. Whether that trade-off is worth it really depends on your personal priorities and aesthetic goals.
Every patient is unique &mdash; anatomy, history, physical exam, tissue quality, goals, skin elasticity, and surgical risk profile all change what is indicated / recommended.Because of this, this should not be taken as personal medical advice. The next step is always an in-person evaluation with a board-certified plastic surgeon that can examine you and discuss individualized plan options.
Hope this helps!
&mdash; Georgina Nichols, MD FACS