Is It Possible to Get Rid of These Indents ( As I Refer to Them As E's) in my Arms with out a Arm Lift?

Question

Hi can good lipo do the trick or is having a scar my only option? Also I was born with these indentations; however ironically the skin around that area is fairly tight. Also I was heavier in the past and lost weight; however my arms (well the indents/rolls have seemed to become more defined not in a good way :/ Ive searched this site endlessly and have not come across anyone with arms like mine. Thanks for your time in advance!

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether it's possible to get rid of indents in your arms without an arm lift. These indents are thought to be due to your genetics. You may consider looking at your baby pictures. If you had these bands when you were a child it is probable you inherited these from your mother and father. Nonetheless, to treat these indentations. I would suggest two options: the first option includes liposuction on either side of the indentation, this brings "the hills" down. Then, I would harvest fat from the abdomen or love handles and transfer this fat to the valley or the indentation. Thus the end result would be that the hills around the indentation would come down. The indentations come up. This should result in a smooth service. Another option that I've employed is been direct incision of the scar. This winds up in a Z plasty. This definitely removes the indentation. However it leaves a zig zag scar. Thank you for your question regarding whether it's possible to get rid of indents in your arms without an arm lift.
I specialize in arm lifts.  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 contact my office.  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 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. (“Verified” 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.)

Richard J. Bruneteau, MD · Answer

It's not unusual for patients to develop redundant saggy upper arm tissue after a significant weight loss. When this situation arises, a variety of treatment options are available. The specific choice will depend upon the patient's aesthetic goals and anatomic findings.Although your pictures are helpful, it's virtually impossible to make a specific recommendation without a physical examination. In the absence of an examination, your pictures suggest a significant amount of excess skin. This excess skin will almost certainly require a brachioplasty with an incision along the inner aspect of the arm. In some cases, an axillary incision will be necessary as well.It's important to realize that this type of procedure involves a series of trade-offs between excess saggy arm skin and additional scarring. For this reason, it's tempting for patients to opt for procedures that have less scarring. Under these circumstances, patients may be left with residual skin sag.If you're considering this type of procedure, it's important to thoroughly discuss these issues with a board certified plastic surgeon. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Stefan Mark Szczerba, MD · Answer

Since you are trying to avoid an armlift, discuss with with plastic surgeon, liposuction and perhaps even the option of ultrasonic liposuction or laser liposuction. These added energy sources during liposuction may tighten your skin and decrease your chance of needing an armlift. If there is too much skin after the liposuction heals, you may then more accurately evaulate your skin crease situation then.

Gerald Minniti, MD, FACS · Answer

Hello,

	Thank you for the informative photographs and explanation of the issues you are having with the appearance of your arms.  I understand your lack of enthusiasm for having an arm lift with the attendant scar that goes along with it.  Unfortunately, the problems you're having are associated not only with excess fatty tissue, but also skin laxity.

	Any significant alternative to an arm lift does not exist, and an arm lift is the only surgical technique that will eliminate your 'E" and give you a flat/straight contour to your inner arm.  The list of inadequate substitutes includes the myriad of devices that pairs liposuction with some high tech energy source like ultrasound, Vaser, waterjets, or lasers like the 'Smart lipo' and 'Lipolite'.  Please beware:  there are many surgeons, even those certified by the American Board of Plastic Surgery, that have purchased these expensive machines and now feel compelled to sell patients on the 'amazing results' that these machines can produce, especially skin tightening.  The fact of the matter is that there is no evidence whatsoever that these machines can tighten skin in any meaningful way more than liposuction alone.

	I recommend you visit a few surgeons certified by the ABPS and are members of the ASAPS who do NOT use these devices and have them assess you.  A very good alternative might be, as you said, very good liposuction to see if just reducing the amount of excess fatty tissue has enough of a beneficial effect to make you satisfied.  It wont make your 'E' go away, but it might make it slightly better and have an overall improvement to your arm contour. The downside to this though is the possibility of making some irregularities worse, increasing the necessity for an arm lift.  The risks, benefits and alteranatives will be discussed and then you can decide on what, if anything, is best for you.

	Best of luck.

Raj S. Ambay, MD · Answer

There are many causes for flabby arms. Incisions can be very small or large depending on location of fat. If one has flabby arms, the best indicator of the treatment would be the elasticity of the skin. If the skin has good elasticity, then Liposuction alone may be the answer. If not, then an arm lift to resect the excess skin is best. However, the best indication for an arm lift, and the most gratifying are those who have lost a lot of weight. The skin is usually flabby and overstretched. It is simple and effective to remove the skin that has been stretched past its capacity. No Liposuction, or other noninvasive modalitiy will help the skin become more firm around the arms. The length and type of the incision will vary depending upon the location and the amount of fat in the arms. The cost will also vary by geographic locale. Most will run anywhere from $3500-$7000. I would advise you to visit with a board certified plastic surgeon to have treatment recommendations specific to your concerns.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.

	Assuming you have reached a long-term stable weight, you may be an excellent candidate for arm contouring surgery. I would not suggest any operation ( including liposuction surgery)  except for arm  lifting. In your case, it may be that a relatively short  excision and ( resulting scar) will be effective given the appearance of your arms in the posted photos.

	The arm lifting operation is an excellent operation that will treat the “sagging arms”;  the downside of course is the long scar ( that can be problematic and require revisionary surgery).  In my opinion one of the keys to this operation is to plan the excision such that the resulting scar  falls along the lower border of the arm ( and therefore is not visible from the front or back views).
	I hope this helps.

Samir Shureih, MD · Answer

you need a good examination to determine the best approach.

	You may benifit from liposuction and a T type of incision for arm lift or modified arm lift.

Jourdan Gottlieb, MD · Answer

These indents are related to tightness in the arm skin, not so much excess fat. I think that liposuction is likely to accentuate what bothers you in  that the skin above the indentation will be looser than it is now. 

	The solution to this would be an arm lift. Only an in person exam could tell, but it may be possible to do with less than the usual length of incision.

	Thanks for your question, and for the attached photos. Best wishes.

Is It Possible to Get Rid of These Indents ( As I Refer to Them As E's) in my Arms with out a Arm Lift?

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