I am considering a modified brachioplasty. I have attempted to research the technique without success. I was able to inquire on how many layers of sutures and type, incision location but not really the technique. I see some surgeons are able to address the "suspension" while others seem unable to-just by image reviews. I wondering if thats the reason for the extended incision that shows (angles upwards to the shoulder). I want to be as informed as possible for the best outcome. Thank you!
What Questions Should I Ask when Considering a Modified Brachioplasty?
Doctor Answers 10
Brachioplasty is an arm lift
Brachioplasty is designed to remove excess upper arm skin (and some cases, fat as well) and requires an incision that runs from the underarm area to the elbow. The scar is placed in the inner aspect of the upper arm, facing the side of the chest, to help conceal its presence. This is a great operation for fair-skinned patients who are generally in their fifties or older, as the skin is often fairly thin, and results in a scar which is faint and minimally visible. In younger patients, this fairly long scar tends to widen, become pigmented, and even thicken - which means that younger patients must seriously consider if the scar is an acceptable trade-off for the improvement in upper arm contour.
In some cases, when the skin excess exists primarily in the upper half of the upper arm, the skin excision can be performed in the underarm area only, avoiding the scar along the inner aspect of the upper arm. Underarm incision brachioplasty can often be combined with liposuction to produce a very favorable upper arm contour. This can be a good option for some younger patients and for those with more deeply pigmented skin. In some patients with an 'in between' amount of skin laxity, the underarm incision may be combined with an incision that extends only halfway down the arm, thereby avoiding the 'armpit to elbow' scar
Upper arm recontouring with liposuction only
In some patients, a nice improvement in upper arm contour can be accomplished with liposuction alone. Individuals that have a minimal excess of skin, in whom the 'sagging' appearance of the upper arms is mainly due to excess fat, are good candidates for liposuction of the upper arms. The better the upper arm skin tone, the better the liposuction result will be. If the skin tone is somewhat lax, the improvement may not be as dramatic as with a formal brachioplasty, but the long upper arm scar is avoided.
As with all plastic surgery procedures, the approach to surgical rejuvenation of the upper arms must be carefully individualized to meet each patient's specific circumstances and personal goals.
Short incision and long incision arm lifts
The most important strategies in arm lifts have to do with how much skin laxity exists and where is the incision placed. The reason that short scar incision don't usually work is that patients seeking arms lifts are not good candidates for that procedure. With a significant amount of skin laxity a longer incision is necessary. Incision location is crucial.
Modified Brachioplasty Is Rarely Effective
The armpit incision only brachioplasty is effective for only a select few individuals who have minimal laxity or redundancy and excellent skin elasticity. There is no magic. If the skin is lax, redundant, or has poor elastic qualities, it will not be improved without excising that skin that is hanging, which will lead to a traditional T scar. the length of the incision down the arm is dependant on each person.
The quality of the scar can be improved by suture techniques performed during the surgery. A combination of deep and superficial long lasting sutures will support the tissue during it's healing phase and minimize scar spreading. The scar can also be improved after the surgery by reducing the tension on the incision line using a porous, elastic tape that is replaced every couple of weeks for three months. This has had a significant positive effect on the appearance of scars after brachioplasty.
I hope that this helps you. You should consult with surgeons who specialize in body contouring surgery and who are certified by the American Board of Plastic Surgery. I wish you the best of luck!
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You realy should discuss this thoroughly with your plastic surgeon before the surgery.
The extent of brachioplasty and the incision and any modification depend on how much excess skin you have and where is the excess skin, How much fat. is there any excess skin at the elbow, any excess skin in the posterior axillary area,
Traditional brachioplasty puts an incision from the axilla to the elbow on the inside of the arm. some people may need less than that or more that that and that is what is called modified brachioplasty. So it depend on your anatomy and what is your surgeon thinking after he examined you.
What Questions Should I Ask when Considering a Modified Brachioplasty?
A modified Brachioplasty, as it says is modified to be tailored to a specific set of patients with arm skin and fat excess and laxity. So the question you should be asking is I am one of those patients.
A modified Brachioplasty was designed in order to avoid the unsightly scars that may develop after a standart Brachioplasty procedure and is limited to an incision in the axillary area to hide the scars.
The degree of skin laxity and fat excess needs to be evaluated and the procedure tailored accourding to it.
The importance of "anchoring " the SFS (superfical facial system) of the arm skin to the chest (clavipectoral fascia) has been described to add supprt and longevity to the procedure.
What kind of arm lift do you need?
The appropriate type of arm lift (brachioplasty) is determined by the amount of excess skin. If there is only a little skin excess, a minimal incision approach is possible. A lot of redundant skin will reqire a full arm lift.
The contouring of the upper arm is a procedure most plastic surgeons will perform. If there is good skin tone and some extra fatty tissue present, liposuction may be performed alone. If there is an abundance of loose skin then the skin and the fat will need to be excised (removed) and the skin flap advanced and closed. This is the Brachioplasty procedure. There will be scars. The overall results are usually very good.
Modified Arm Lift. What is it?
I have no idea what a modified arm lift is and I have been doing this surgery for 30 years. Modified means the surgeon has modified things to his or her own taste. This is fine but there is no such defined procedure. Arm lifts can be either pure liposuction, pure long incision, or one of the 75,000 combos in between. The axillary incision (armpit), is a wishful thinking bit of nonsense usually. Little, if anything, is accomplished by the so called Brasilian Armpit incision. This incision is more about psychiatry and mental impression than accomplished fact. On the other hand, if the patient is happy, the armpit psychiatry worked I guess. Live forward!
As there is no standard "modified brachioplasty," I would be concerned about exactly what your surgeon has planned and how well it works.
John Di Saia MD