Hello, Thank you for your question about the different incision placements for arm lifts (brachioplasty) and the reasoning behind these surgical choices. The placement of the incision during an arm lift can vary, with some surgeons opting for the back of the arm and others choosing the inside of the arm. Each approach has its advantages and considerations. When the incision is placed on the back of the arm, one of the main reasons for this choice is the relative ease of the procedure. This approach is technically simpler and allows for the avoidance of nerves and lymph nodes, potentially reducing complications. However, a significant downside is the visibility of the scar. With your arms down at your sides, the normal resting position, the scar on the back of the arm can be quite noticeable. While many general surgeons might opt for this approach, most plastic surgeons tend to avoid it due to the visibility of the scar. On the other hand, placing the incision on the inside of the arm is often considered superior by many plastic surgeons, despite being technically more challenging. This approach does involve navigating around nerves and lymph nodes, which can increase the risk of complications slightly. However, the major benefit is the concealment of the scar. The incision is typically made in the bicipital groove, between the biceps and triceps muscles, making the scar less visible when your arms are at your sides. While the scar may become more apparent with the arms raised, this is a less common position in daily activities. In conclusion, the decision on incision placement depends on balancing factors such as ease of surgery, risk of complications, and scar visibility. Most plastic surgeons prefer the inside of the arm for the incision due to the less visible scarring, despite the increased technical difficulty and slight increase in complication risk. I hope this explanation clarifies the reasoning behind the different incision placements for arm lifts. Wishing you the best in your journey. Good luck.