Crepey skin on neck and arms after weight loss: would I get good results from an arm lift? What about my neck? (photos)

Question

Hi I am 39 years old female and went through gastric bypass three years ago and lost 100 pounds I am 20 pounds away from my goal weight. However I hate the sagging skin I have on my arms. I really dislike how my skin looks because it looks wrinkly. Even my neck looks wrinkly. It does not look like skin of a young person. Is it normal to have creepy skin when you have lost so much weight?I've shared some photos. Wood I get good results now if I had a arm lift? And what is up with my neck?

Kenneth Hughes, MD · Answer

Hello, thank you for your question. It seems like you may benefit from arm lift. An L-shaped brachioplasty or an extended brachioplasty combines the arm pit incision with an incision hidden on the inside of the arm. Patients who have lost a significant amount of weight or have a great deal of loose skin may benefit from this more extensive arm skin reduction and lift. This extended arm lift allows more fat and skin to be removed and it can produce a much better contour.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding crepey skin on your arms and neck after weight loss and would you get good results with an arm lift. Thank you for your history and your pictures. Congratulations on your weight loss; that is a great accomplishment! In regards to your arms, you have excess arm skin and fat to the elbow. This means the arm skin and fat needs to be removed. This is achieved through a longitudinal arm lift. During an arm lift or brachioplasty, arm liposuction is performed, and an incision is made from your armpit to the elbow. A large elliptical skin and fat is then removed from your arms. In my hands, I can reduce the circumference of your arms by approximately 40%. At the same time, I would suggest a neck lift. This would be achieved by an incision around the ear, dissection down to the neck and the neck skin would be pulled tightly. In addition, I would also suggest plication of your neck muscles mainly the platysma muscles. In my opinion, with your weight loss history, age and from your pictures, neck liposuction alone will not suffice. In my opinion, you need a neck lift. The neck lift can be combined with the arm lift as an outpatient procedure. The neck and the arm lift will be done under general anesthesia and will take me approximately 6-7 hours. Please seek a board-certified plastic surgeon in regards to your arm and neck lift. I hope that I have answered your question regarding what to do with crepey skin on your arms and neck after weight loss and would you get good results with 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 your arm lift case is special and requires a revision, which is more difficult than an initial arm lift, 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 , 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.)

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

Ajaya Kashyap, MD · Answer

Congratulations on your weight loss and thank you for your question. It appears that you would benefit from an extended arm lift, based on your pictures. This is a relatively common procedure that I do for massive weight loss patients whose arms have loose saggy skin as you seem to have . Please find an experienced Board certified plastic surgeon who can help you with all your concerns.. All the best!

Francis Johns, MD · Answer

Thank you for your question.I would recommend achieving your goal weight or being within 5-10 pounds of it. A 20 pound weight loss could change the results of your surgery. Based on current photos, I do believe you would be a good surgical candidate.

Carmina Cardenas, MD · Answer

It is a very common feature to see premature aging on patients after Massive Weight Loss. I have seen patients, 20 YO with saggy skin all over the body because of the MWL, and face is a common area.So it will be very important to let you acknowledge that you must be stable on your weight before doing any type of surgery because if for a reason you end up losing more weight after the surgery, and having in mind your skin and tissues do not have a good elasticity anymore, you will develop saggy skin again.It will me mandatory to see good photos to make a proper evaluation regarding your neck, but you arms will definitely need a Full Length Arm Lift in order to get rid of the saggy skin. No conservative procedures will eliminate the saggy skin or will tighten it. Liposuction will make it worst. So be encouraged and must be very proud of what you have achieved already.Dr. Cardenas

Daniel Barrett, MD · Answer

Dear kaboom7580,
this is a common problem after weight loss and in most cases, non-surgical methods don't provide good results. Based on your photos, it looks like you would benefit from arm lift. If you are considering a surgery, I would suggest you to 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

Camille Cash, MD · Answer

Congratulations on your impressive weight loss!  From the submitted photos you appear to be a good candidate for an arm lift.  This will remove excess skin and fat and give your arms a nice contour.  I've included a video on this procedure that I hope you find helpful.  More photos or an exam is needed to determine the best recommendation for your neck.  If it is mild laxity you could consider FaceTite, but for more severe laxity a lower face and neck lift would give you the desired improvement.

Michelle Copeland, MD, DMD · Answer

Thank you for sharing your photos! Although it is difficult to say
without an in person examination, if you have good skin elasticity, you should
be a good candidate for an arm lift, neck lift  and liposuction.
 Lifts on this famously wobbly part of the human anatomy—known familiarly
as “Hi Janes” or “Bingo” arms—are particularly popular. Heavy and even
moderately droopy arms can be recountoured very effectively with liposuction.
Liposuction modifies volume by sucking out fat and because liposuction stimulates
the skin to tighten, good elasticity provides a smooth contour after fat is
removed. I use several innovative forms of liposuction, including
SmartLipo, in order to contour and resculpture the area while providing the
most beautiful results with minimal scarring.
If a patient is left with severely hanging skin as a result of age
or weight loss, a brachioplasty will be the most effective procedure—though
once again, the trade-off for tightness is a big scar. Today an arm lift
(brachioplasty) procedure takes a relatively quick two to three hours,
typically under twilight sedation and local anesthesia. Your surgeon will need
to make a considerable incision, nearly a foot long from armpit to elbow. The
excess fat is sucked out using liposuction, the underlying connective tissues
are tightened, extra skin is removed, and the skin is sutured into place. Your
mobility isn’t as restricted as after a lower-body lift, and many patients find
they can return to work after a week. Do not, however, carry heavy bags, attempt
any upper-body exercise, or raise your arms over your head.
You may also get improved neck contour with small incision surgery
using a combination of liposculpture techniques that remove fatty neck deposits
and help tighten skin. The neck lift is an easy way to reduce jowls, eliminate
a double chin, slim the bands of muscle that form the wattle, and tighten neck
skin. Typically, a surgeon will also decide to perform a lipectomy, suctioning
out fat in order to resculpt the area. A lipectomy is performed through an
incision less than a centimeter long under the chin and a 2 mm incision in the
crease of the earlobe. A cannula is then inserted and fat is liposuctioned out
in order to resculpt the neckline. If a neck lift is also being performed,
excess skin will be removed. This can be done under twilight sedation with
local anesthesia, instead of general anesthesia.
I suggest you make an appointment with a board certified plastic surgeon to discuss what treatments are right for you.

Gilbert Lee, MD · Answer

Thank you for your photos and questions. Based on these photos, you look to be an excellent candidate for an armlift. It is typically done in conjunction with liposuction. The liposuction will sculpt your arms down and the lift will remove any excess skin that remains. For your neck, you may be a candidate for Neck Tite. This is a technology that uses radiofrequency to shrinkwrap the tissues. This system will not give you the same result as a surgical necklift but given your age, may tighten the tissues enough and has very minimal scars. In our office, we offer 3D imaging to give our patients an accurate idea of what their final result will look like. Good luck!