Reconstruction needed after arm lift - What is the best approach? (photos)

Question

I’m hoping to get advice as I’ve researched and can only find surgeons that do arm lif scar revision not reconstruction. My arms- left is worse but both had too much skin taken from above the elbow and I have a tight band across it. It looks deformed. It’s uncomfortable and looks horrible. I have to always wear 3/4sleeves. Would gentle liposuction to the forearm and elbow work- it’s a delicate area with veins and arteries I know, would a reconstructive surgeon be best. After ideas please

J. Timothy Katzen, MD, FACS · Answer

Hi Mish8874,
Thank you for your question regarding reconstruction after your arm lift and what would be the best approach. I think it is very important for you and your plastic surgeon to analyze what bothers you. You also need to analyze your pre-operative arm pictures to discover if that band was there before surgery. Reconstructive, aesthetic, or cosmetic plastic surgeon titles really don’t matter. All surgeons should treat tissue gently. What you need is an expert in armlift surgery whether they are labeled as a reconstructive plastic surgeon or aesthetic plastic surgeon.  
I don’t think liposuction of the forearm or elbow is a good idea. The medial epicondyle or the inner portion of the elbow will still stick out even with the most aggressive liposuction. 
Therefore, what I would suggest would be a Z-plasty in the right arm construction band. This will migrate local tissue into the scar. I would also suggest fat transfer into the band to fill the indentations. Fat transfer may be required several times to give optimal results. I would also suggest liposuction to be done on each side of the band. By doing liposuction and fat transfer, you are filling in the “valleys” and bringing down the “hills.”  I hope this helps to answer your question regarding reconstruction after arm lift with an arm band. 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.)

Sincerely,

Connie Hiers, MD, FACS · Answer

Too much skin was removed in that area. Liposuction could be done above and below the area and try radiofrequency skin tightening in those area. If the skin is too lose once healed, then a revision lift would be needed. A skin graft by itself will not add volume. A fat transfer might be tried if the skin is not too tight. A small tissue expander could be put in to slowly stretch that area and then add fat. but this is not a good area for the expander.

Camille Cash, MD · Answer

From the photos provided it appears you will need a revision for improvement and unfortunately it may be complex.  I encourage you to visit with a few board certified plastic surgeons near you to hear varying opinions. Liposuction alone may not give you the improvement desired.

Kaitlyn Paine, MD · Answer

You should see a board certified plastic surgeon to perform a physical exam, so the treatment can accurately reflex what the deficiency is. Indentations can be caused by several different things but generally there is either a not enough soft tissue (i.e. often fat) or not enough skin. This is a difficult issue to treat and you would want to see someone who focuses on body contouring. Ideally treatment would need to consist with replacing some of what was taken with the previous surgery. I would first discuss this with the surgeon who performed the initial surgery. You can to see what they would do to revise the area. I would also suggest getting the opinion of a few other plastic surgeons. You will likely find several different approaches to treating the issue. Ask lots of questions and find someone that makes you feel comfortable and you can have a good relationship with.

Reconstruction needed after arm lift - What is the best approach? (photos)

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