Exercise vs Lipo vs Arm Lift - how can I fix under arm flab? (Photos)

Question

48yo female 164lbs, 5’11. I have lost around 30 lbs. I work out 4 days a week, cardio and strength. I have always had under arm flab since I was in my 20s. My muscles are definitely becoming more defined in My arms. I am still on my weight loss journey - maybe 9-10 more lbs. Would I be able to get away with just more exercise/strength training to get rid of the flab under my arms (it has definitely reduced some since working out)? Or at minimum Lipo?

J. Timothy Katzen, MD, FACS · Answer

Hello Sharinole, 
Thank you for your question regarding exercise vs lipo vs arm lift and how can you fix under arm flab.  Thank you for your history and photos.  Since you are planning further weight loss, most plastic surgeons would suggest that you first achieve your weight loss goal.  Then, really hit the gym with weightlifting and resistance training to target the triceps.  Targeted triceps routines can be found online.   It is highly unlikely that your skin will contract based on your age, weight-loss history, and pictures.   You may be able to build enough triceps muscle mass to fill out this area, but you’ll have to work for it.  First, we should analyze your pictures to determine the best procedures.  You have arm cutis pleonasmus (excess skin) and dermatocholosis (loose skin).   If you cannot fill this area with muscle, an arm lift (arm reduction or brachioplasty) would be your best option.  Since you have excess skin, liposuction would only remove arm fat, not arm skin.  If arm fat is removed with arm lipo, more hanging skin will remain.  Even if you use VASER or RF, your arm skin will sag.  Therefore, if you cannot get the arms you want with exercise, then undergo a brachioplasty.  In your case, the brachioplasty incision would extend from the axillae to midway down your arm (based on your pictures, not physical exam).  The brachioplasty takes about 3 to 4 hours to complete under general anesthesia.  Allow yourself a 10 to 14-day recovery.  Back to the gym for lower body at about 2 to 3 weeks and upper body at about 4 to 6 weeks.  I hope I have answered your question about exercise vs. lipo vs. arm lift and how to fix underarm flab.  If you have any more questions regarding the arm lift, arm reduction, brachioplasty, arm scar revision, or arm crease fat grafting, contact an experienced plastic surgeon.  To get an accurate assessment of what exactly you need, schedule a free virtual consultation.  Most plastic surgeons offer free virtual consultations.  Since an arm lift can be a challenging surgery, please seek an experienced, board-certified plastic surgeon with extensive experience performing these lifts.  Do your research.  Make sure they have performed at least 150 arm lift procedures.  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, MD, MBA, FACS, FICS (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.)

Guray Yesiladali, MD, FEBOPRAS · Answer

What you are describing is primarily related to skin redundancy rather than muscle tone alone.
When you strengthen the underlying tissues, the overall contour of the arm can improve. However, tightening the muscle does not reduce the amount of skin that surrounds it.
You can think of it like a pillow. If you compress the filling inside, the pillow may look smaller, but the fabric covering it can begin to wrinkle or appear looser. Similarly, reducing fat or building muscle improves volume, but it does not shrink the skin envelope.
In your case, there is no absolute indication that surgery is mandatory. The decision depends entirely on how much the remaining laxity bothers you.
Liposuction alone is not the appropriate solution when skin laxity is present. Removing fat without addressing the skin can sometimes make the looseness more visible.
If a definitive correction is desired, brachioplasty (arm lift) is the procedure that addresses excess skin directly. However, it is very important to complete your weight loss journey and reach a stable weight before surgery. Being at a stable weight directly affects the long-term durability of the result.
I wish you continued success on your journey and clarity in choosing the option that best aligns with your expectations and long-term goals.
&mdash; Güray Yeşiladalı, MD

Laura Roider, MD · Answer

Thank you for sharing your photos. Unfortunately, it is impossible to exercise or liposuction away loose skin. Which exercise and liposuction are great at removing excess fat. 
Based on your photos you have fairly tone arms with mild residual fat and moderate excess skin. I would recommend achieving your goal weight and then consulting with a plastic surgeon to discuss skin removal options.

Luis A. Mejia, MD · Answer

Hello, thank you for your question.. From the photo you send and after evaluating your case, there are some excess of skin on your arms area... an Arm lift is needed to crrect this and improve it.

Exercise vs Lipo vs Arm Lift - how can I fix under arm flab? (Photos)

Answers (4)

More Arm Lift Questions

Skin laxity and lumpiness - Am I a candidate for a MINI arm lift? (Photos)

Should I try 4D PAL liposuction first for arm lipedema, or proceed directly with an arm lift? (Photos)

Can this mini arm lift scar be shortened? Will a revision help? (Photos)

Brachioplasty incision is lumpy two years post op - can this be fixed? (Photos)

Can combining a breast reduction incision up to an arm lift incision address some upper back laxity? (Photos)

Lipo made my arms look worse. Is an arm lift my only option? (Photos)

WE SEND PRETTY
EMAILS