I need to have arm lift surgery but I still have weight to lose, do I have to wait until I hit my goal? (photos)

Question

I have lost 100 pounds over the last 3 years, doing it with diet and some exercise, but I still have 80 pounds until I hit my goal. I recently moved to Palm Bay, Florida and I can't stand my arms in bathing suits and I would like to go sleeveless now. I am 63 years old and arm exercise is doing nothing to help. I was 385 and now I am 279. Would it make that much difference if I waited? My weight loss is so slow now and my arms are such an embarrassment. Thank you.

Thomas Trevisani, MD · Answer

Congratulations on your massive weight loss! This requires commitment and dedication. It is my opinion that you would benefit at this time from bilateral brachioplasty ( arm lift). Most all of the excess skin and fat that exists on your upper arms at the present time- can be removed with surgery. The incision site will extend from your elbow to your axilla in the groove of your biceps muscle.

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your questions regarding the fact that you require arm lift surgery, but you still have weight to lose, and do you have to wait until you hit your goal weight before arm surgery.  Thank you for your history and your arm pictures.
Your case is why every plastic surgeon should treat patients as individuals.  The classic plastic surgery teaching says that a patient should lose as much weight as possible and be stable at that weight for three months before embarking upon reconstructive plastic surgery after significant weight loss.  You may have an ideal body weight or a BMI of less than 30.  Therefore, classically, plastic surgeons recommend you lose all your weight before embarking upon your arm reduction, arm lift, or brachioplasty.  However, most experienced plastic surgeons would recommend that you have your arm lift now.  Several things support this opinion, including your age, the extent of your arm anatomy, geographic location, hot climate, and wishing to go outside by the pool.  Also, you mentioned that further weight loss is slowing down.  Not to be discouraged, but it may be very difficult for you to reach your goal weight.  Therefore, I recommend you have your arm surgery now.  Even if you lose further weight, it is doubtful you would need a revision.  However, this isn't very certain.  Therefore, you will get the best results if you lose as much weight as possible before your arm lift or brachioplasty.  If, however, you are frustrated with the situation based on your age, a significant amount of excess arm skin, arm fat, being in a hot climate, and wishing to go outside by the pool are all indications that you can undergo your arm surgery before reaching your ideal body weight.  You must also realize that you will not get the best result if you undergo a brachioplasty before reaching your goal weight.  However, you will get adequate arm lift results.  Good luck.  I hope I've answered your question regarding the fact that you require arm lift surgery, but you still have weight to lose, and do you have to wait until you hit your goal weight before arm surgery.  I hope that I have answered your questions regarding the arm reduction.  If you have any more questions regarding the arm lift, arm reduction, brachioplasty, or arm crease fat grafting, please get in touch with an arm lift expert.  Since a brachioplasty or arm lift surgery is difficult, 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 100 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.  (Plastic Surgeon, President of the American Society of Bariatric Plastic 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 and RealSelf Hall of Fame.)Sincerely, Dr. Katzen.  (Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Ira H. Rex III, MD · Answer

If you were just considering losing 10 to 15 pounds, then it would probably be reasonable to proceed with your surgery. If you will truly meet your goal of losing 80 pounds, I would recommend waiting to have surgery. Once corrected, your arms should have everlasting improvement. This could easily be compromised with such significant weight loss.

Nelson Castillo, MD · Answer

Thank you for your question and photographs, and congratulations on your massive weight loss!  It is always wise to pursue an elective aesthetic procedure after you've reached your goal weight as it leads to the best long term results.  It is possible to have the surgery now if your arms are causing you such discomfort and embarrassment, but you would need to be willing to accept some additional skin laxity if you were to lose another 80 pounds or so.

Jeffrey Antimarino, MD, FACS · Answer

congratulations on your successful weight loss.  80 lbs is still a significant amount of weight to lose and may change your surgical outcome if you do surgery prior to the weight loss.  I'm curious as to how you came up with your goal weight.  Best if your goal weight was set with a nutritionist or MD.  You may also want to see a board certified plastic surgeon in the meantime to examine you.  Your arms may reach a point when it would be safe to undergo a brachioplasty prior to an 80 lb wt loss.

Julio Clavijo-Alvarez, MD, MPH, FACS · Answer

Great job in your journey. You should feel very proud of your achievement.To answer your question:If you have your surgery and continue loosing weight, it might be possible that the saggy tissue might happen again. This might represent another surgery in the future.If you feel that your arms will stay the same or that you won't be loosing much more weight, then surgery should be the right answer for you now.Once again congratulations. Wishing you best of luck.

Mel T. Ortega, MD · Answer

Great work on the weight loss. I recommend my patients to be at their goal weight when they are considering any lifting procedures. If you decided to have the procedure done now and you end up loosing 80 lbs later you would end up where you started. You should see a physician about helping with the weight loss. This way you achieve your results a bit faster and end up having your arm lift sooner. Hope this helps.

John J. Edney, MD · Answer

Ideally patients should be within 10 pounds of their ideal body weight before undergoing body contouring surgery.  Sometimes however certain parts of the body gain and loose fat differently than other parts of the body.  If a physical examination of your arms indicated that you have very little residual excess fat would be reasonable to proceed with a bilateral arm lift.  Good luck

Camille Cash, MD · Answer

Congratulations on all of your hard work!  When considering surgery such as this, you will get the most reliable results when you have the procedure after you are near your goal weight and you are no longer noticing changes to the area being treated.  You could consider having the procedure done now to take up much of the excess tissue, and then have a revisional surgery once you have reached your goal weight.  Under either circumstance I encourage you to visit with a board certified plastic surgeon in your area to evaluate your situation and advise you based on your medical history and surgical goals.  Good luck!

Darryl J. Blinski, MD · Answer

Way to go and keep it up.... Best to seek only in person opinions from private practice boarded Plastic Surgeons in Florida. I might consider a 2 stage operation for you, but need to see in person.

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