Arm lift with only 3/4 long incisions/scars, or full length to the elbow? (Photo)

Question

Is this method sufficient, if there is a certain amount of loose skin / fat, near the elbow? (I only have it on left arm) I have seen two different plastic surgeons, and they are of two different opinions. One says that the scar has to go all the way down to the elbow, and the other one says, that only 3/4 long incisions are sufficient, when the skin at the elbow is pulled up towards the armpit, and tightened that way instead. I would really like the shorter scar, but I'm afraid of bulging

Daniel Barrett, MD · Answer

Dear ani6767,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would need longer incision in order to get the best results. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question about choosing between a ¾ length incision and a full-length incision extending to the elbow for an arm lift. Your history and the photos you've provided are instrumental in addressing your concern.
Most plastic surgeons would concur that the optimal treatment for your arms would be a combination of arm liposuction and a longitudinal brachioplasty, involving an incision from the armpit to the elbow.
During a longitudinal brachioplasty, the incision is made from the armpit to the elbow, with tissue dissection extending to the triceps. The excess skin is rotated upwards toward the biceps, and a significant elliptical portion of arm skin and fat is removed. The direction of the skin removal is along the long axis of the scar, ensuring that the elbow does not get unnaturally "pulled up towards the armpit."
Therefore, a full-length longitudinal brachioplasty is generally recommended as the best option. If you've been advised to consider a 3/4 length incision, it's crucial to request before-and-after pictures from your surgeon showing patients with similar arms and incisions. Study these images carefully. If such examples are not available, it might indicate that the 3/4 length approach may not be as effective in achieving desired results.
I hope this information assists you in deciding whether to opt for a 3/4 length incision or a full-length incision for your arm lift.
Good luck.
Sincerely,
Dr. Katzen

Andrei Rios, MD · Answer

Hello ani6767, I've seen many cases of patients who need arm lifts. In my personal opinion, you have to commit to a complete full length incision to prevent bad results. When we release the skin and pull, we move the skin that has been released towards the area we want to (in this case the arm pit), but if the skin around the elbow wasn't release, even if it doesn't look as saggy, it will not move accordingly with the rest of the skin. The results would be more skin/volume around the elbow than around the rest of the arm. Having said that, if one surgeon you're consulting makes more sense and gives you more confidence, you should go with him/her regardless of recommendations offered.

Kristopher Hamwi, MD · Answer

I suspect that your incision would need to go from your arm pit to your elbow. The ends of an incision tend to have less pull and effect so in order to get the most skin out and have the most even contour the incision needs to go a little longer in your case.

Gary M. Horndeski, MD · Answer

At the time of brachioplasty, the surgeon will most frequently liposuction the area of the elbow as well as the arm. If you have minimal fat there and your skin tone is good then you may be able to get by with a shorter incision.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

Let me suggest a third option. consider minimally invasive skin tightening with radiofrequency like Renuvion and liposuction. You might do well with very tiny scars.

Camille Cash, MD · Answer

Having a shorter incision length will not likely be as important to you as the contour of the arm.  In other words, if the incision is shorter but the arm contour isn't smooth your result won't be as good.  I've included a video on the pros and cons of this procedure that I hope you find helpful.

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