Advice on procedures to get rid of my loose skin? (Photo)

Question

I used to weigh 210lbs now I weigh 140lbs. I want to get surgery to get rid of my loose skin in my arms, armpits, back and side of my breast. I don't know if I should get a mini arm lift or a regular arm lift and if I should get the incision in my armpit or down my arm? But I also want the loose skin in my armpit and down to the side of my breast gone and my back rolls. I don't know what would be best for my body.

Anna Chacon, MD, FAAD · Answer

First, congratulations on losing 70 pounds. That is a tremendous accomplishment and reflects a great deal of dedication. Loose skin after significant weight loss is very common, and it's understandable that you're looking for the best way to address it.

Based on your description, it sounds like your concerns extend beyond the upper arms alone. You're also noticing excess skin in the armpit, the side of the chest near the breasts, and the upper back. When these areas are involved together, it's important to think of them as one continuous contour rather than treating each area separately.

For the arms, the type of lift depends on the amount and location of excess skin:

A mini arm lift, with an incision hidden in the armpit, is best for people with only a small amount of loose skin confined to the upper arm near the axilla.
A standard brachioplasty (full arm lift), with an incision extending down the inner arm, is usually recommended when there is more extensive skin laxity. It provides much more dramatic tightening but does leave a longer scar.

If the loose skin continues from the armpit onto the side of the chest or toward the breast, many surgeons consider extending the procedure into a brachioplasty with lateral chest extension. This allows both the arm and the excess skin along the side of the chest to be addressed in one continuous contour, rather than improving one area while leaving the adjacent tissue unchanged.

For concerns involving the upper back or "back rolls," a separate upper body lift or upper back lift may be appropriate if there is significant excess skin in that region. These procedures are designed specifically for patients who have experienced major weight loss and often provide a much more balanced overall result.

One thing I always emphasize is that the "best" operation isn't necessarily the one with the shortest scar. In body contouring after weight loss, the trade-off is usually more skin removal in exchange for a longer scar. Most patients find that the improvement in contour outweighs the visibility of the scar, especially as scars continue to mature over the course of a year or more.

If your weight has been stable for several months and you're close to your long-term goal, this is generally the ideal time to begin considering body contouring procedures. Stable weight helps maximize the longevity of your results.

From your description, I suspect that a mini arm lift alone would likely not address all of your concerns. Because you're bothered by the arms, armpits, lateral chest, and back, a more comprehensive body contouring plan would probably provide the most harmonious outcome. The exact surgical approach would ultimately depend on how much excess skin is present and how it is distributed, but thinking about these areas together rather than individually usually leads to the most satisfying and natural-looking result.

Andrew Ray, DO · Answer

You have several options for a lot of what you are asking about. Your arms are hard to comment on with these pictures, 
To fix the bra line could be a mixture of breast lift with bra line liposuction, including liposuction and possible renuvion of the upper back to help tighten the skin. Depending on the laxity in your back you could consider an upper back lift instead of the renuvion if you were ok with scars but get maximal results.

Ryan Rebowe, MD · Answer

First of all, congratulations on losing that much weight as that is a huge accomplishment! Based on the pictures you submitted you have much more laxity on your lateral breast and back than your arms. I would recommend something like BodyTite (energy applied to the dermis of the skin to tighten it) for your arms with minimal liposuction, while your back would benefit more from a formal bra line excision.

Carey Nease, MD · Answer

Congrats on losing the weight! Now, to deal with some loose skin....I really don't think you need a brachioplasty as you are young and your excess skin is not too bad there. I like a combination of liposuction with Renuvion for skin tightening for your arms and armpits and back bra rolls. Skin excision could always be done in the future if you don't get as much tightening as you hope. Definitely do not get a mini brachioplasty as it doesn't help much and the scar is not typically very pretty. Hope that helps!

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

Yunus Dogan, MD, FEBOPRAS · Answer

Hello
For the best advice you should have a consultation with a Board Certified Plastic Surgeon.  From viewing your pictures it looks as though you would benefit most from a bra-line lift and possibly a mini arm lift.  Good luck.

Bradley Hall, MD · Answer

From the pictures you have send I can see the excess skin you are talking about on your side. If you were wanting a breast lift, the incision from that surgery can be extended on to the side of the trunk to treat the excess skin of that area. In some situations, patient who are also have a brachioplasty (arm lift) can do both at the same time, but this requires connecting those incisions, so it is a tradeoff, improved contour for scars. I can't tell if you have enough tissue on the arms to justify a full brachioplasty but using body tite or energy to contract the tissue and shrink it may be beneficial in your situation.

Camille Cash, MD · Answer

Congratulations on your impressive weight loss!  From the posted photos it doesn't appear that an arm lift would be necessary.  You could consider something with minimal to no scarring such as liposuction, BodyTite or Morpheus 8.  For your back you can consider liposuction with J Plasma to tighten the skin.  Visit with a board certified plastic surgeon near you for the best recommendation.

Advice on procedures to get rid of my loose skin? (Photo)

Answers (8)

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