During an arm lift, do surgeons always have to remove a bundle of nerves?

Question

My surgeon said sometimes during an arm lift, he has to remove a bundle of nerves in order to remove all of the fat and skin. I was wondering if this happens in every patient or only some. If it’s only some, does it occur in patients with very large arms with a lot of skin?

Zoran Potparic, MD · Answer

Removal of nerves is not part of arm lift surgery. Although some, very superficial nerve brunches, may be removed if very large skin excision is performed, preservation of all the nerves should be attempted. Temporary numbness may be experienced in postoperative recovery in areas around the scar but that should improve within 6 months after surgery. You should discuss this issue with your surgeon extensively before surgery to be sure that you have good understanding of possible complications. Good luck.

J. Timothy Katzen, MD, FACS · Answer

During an arm lift do surgeons have to remove a bundle of nerves? Thank you for your question regarding whether surgeons must remove a bundle of nerves during an arm lift, arm reduction, or brachioplasty. I have performed hundreds of arm lifts. I have never had to remove “a bundle of nerves.” There are three main nerves in the upper arm. Two of the nerves are extremely deep and are rarely injured. A more superficial nerve runs through the middle of the operating field. However, this rarely needs to be removed if the dissection is performed approximately. Visualization of this nerve is optimized by performing liposuction during the procedure. This minimizes the chances of the nerves being transected or moved. However, this is a single nerve and not a bundle of nerves. Therefore, surgeons do not have to remove a bundle of nerves during an arm lift. Whether the arms are large or small, the anatomy is very similar, and there is only one nerve. Just because you have very large arms does not mean you have more nerves in that area. I hope this helps answer your question about whether surgeons are to remove a bundle of nerves during 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.)

Kristopher Day, MD, FACS · Answer

There are always superficial branches of sensory nerves that come out with any surgery that removes tissue. However, no "bundle of nerves" should come out with an arm lift. There is a particular forearm sensation nerve, called the medial ante-brachial cutaneous nerve that must be carefully avoided in brachioplasty, or upper arm lift. This is done by leaving some the tissue down on the deeper layer of the tissue that wraps around the muscles. A carefully down brachioplasty thus preserves all "named" or "major" nerves.

Stefan Mark Szczerba, MD · Answer

That's a odd answer... I have never heard that before.  There are nerves to the segment of skin that is being removed.  Liposuction can be done about 3 months or 6 months before that will reduce the amount of skin (and the nerves to the skin)  that needs to be removed.  Additionally InMode BodyTite can help shrink the skin to make armlifts sometime unnecessary.  Best Wishes!!

Carmina Cardenas, MD · Answer

The regular procedure is to remove all the elipse of skin in-block skin fat and all in between. 
In order to prevent the injuries to important veins, arteries and nerves it was described the technique where liposuction is performed to the 360 circumference of the arm but the elipse of skin is totally deflated in order to preserve nerves, veins and arteries. This is the technique I perform and I have observed patients have a great outcome in terms of volume reduction, skin tightening and also less pain and swollen because of the preservation-debulking technique. 
Your BMI must be below 30 anyways, because of safety. 
Be encouraged!!
Dr. Cárdenas

Daniel Barrett, MD · Answer

Dear Wehores6,
human body has a lot of nerves that go under the skin and provide sensation. In case of arm lift, there is a chance that some of these nerves will be injured. 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

Connie Hiers, MD, FACS · Answer

Most of us try to avoid many nerves, but the superficial sensory nerves can be taken in the area of excised skin. Most of my patients keep sensation.

Melissa Marks, DO, FACOS · Answer

An arm lift procedure (AKA brachioplasty) is a procedure to remove skin and fat from the upper arms. Sometimes this is also combined with liposuction. One of the potential risks of this procedure is injury to the superficial nerves that would lead to pain, tingling, or loss of sensation to the skin on the upper arm. Although this is common risk associated with this type of surgery, It is NOT common for a plastic surgeon to purposefully remove the nerve bundle. 
hope this helps!

John A. Kotis, DO, FACS, FACOS · Answer

Hi 
I perform many arm lift procedures. The technique i use preserves the nerve lattice that is involved in arm lift surgery. I recommend seeing a board certified plastic surgeon.

During an arm lift, do surgeons always have to remove a bundle of nerves?

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