Tail of Spence Removal and Lipo Vs Brachioplasty to Slim and Tighten Arms?

Is there any qualified ps out in Portland, OR or around the Tampa Bay area who are experienced with removing the fat in the underarm area (tail of spence?). I am also wondering who in the same areas of the country can tell me if Lipo on the arms to slim and tighten is just as successful as having a brachioplasty where you have a long scar along your arm. Thank you! Pam

Doctor Answers 9

Liposuction of the Arm and Upper Chest

Upper arms and breast tissue that merges into the armpit (known as the tail of Spence) are both areas that respond well to liposuction.  Make sure you select a surgeon certified by tha American Board of Plastic and Reconstructive Surgery, experienced in liposuction.

Seattle Plastic Surgeon
4.9 out of 5 stars 114 reviews

Lipo of the arms

Liposuction of the arms can be effective. I use a combination of traditional and ultrasonic liposuction which I think helps the skin settle down better. In many cases some skin-fat remaval is indicated. Many times I limit skin removal to the axillary area trying to hide the scar, but some patients need tissue removed all the way to the elbow. I have never removed breast tissue(tail of spence) to do a brachioplasty.You might search for a board certified plastic surgeon in your area,

Terry A. Cromwell, MD (retired)
Lafayette Plastic Surgeon
5.0 out of 5 stars 2 reviews

Liposuction vs. Brachioplasty

It is important that you understand the limitations of liposuction.  This procedure does not tighten the skin but relies on the elasticity of the overlying skin to achieve some retraction.  Most patients, in my experience, are not good candidates for liposuction of the arms.  It is understandable that you wish to avoid the lengthy scar of a brachioplasty but you must be careful to avoid an inappropriate procedure in your desire to avoid the scar.  Obviously you need a consultation (preferably several) with a board certified plastic surgeon with experience in this area.

Richard Kofkoff, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 81 reviews

Underarm contouring

The only problem trying to contour the underarm area by removing the tail of spence is that the skin does not recontour as nicely as one would like.  For certain patients this can be very effective, but the likelihood of a great outcome depends a lot on individual anatomy.

Daniel Greenwald, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 45 reviews

Liposuction of the arms does really nice but never replaces a full brachioplasty if needed.

Loose skin and fat hanging under the arms does improve with the micro canula tumescent liposuctions under local but it can only do so much. In severe cases, an arm surgery called a brachioplasty which does give a noticeable scar is needed. Fortunately, most patients do get a good improvement with lipo alone and that is easy to undergo. It is worth traveling to find the right doc who can do arms great.  Sincerely, David Hansen,MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

Tail of spence and liposuction?

If the tail of spence is prominent in the axilla this can be problematic for some patients.  If it is mostly glandular then direct excision is a better choice than liposuction.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Most women choose arm liposuction, and only have brachioplasties if the skin is very lax.

I commonly treat that area when performing liposuction of the arms and underarms.  Treatment of these areas is highly gratifying to patients but not all plastic surgeons do it.  You are quite correct in your hesitation to have a long scar, which results from a brachioplasty.  Most women have liposuction alone.  This reduces the bulk.  There may be a little tightening effect but this depends on the elasticity of your tissues.  If you have poor elasticity, the skin will not tighten and you may then be better treated with a simultaneous brachioplasty (particularly if you have lost a lot of weight).  Have a look at the results.  I've attached a link to this section of my website.  You can decide for yourself whether it might be worth doing.  P.S. The arm scar is better than a bat wing and experienced surgeons know how to position it to be least obvious.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 56 reviews

Liposuction vs. Brachioplasty for Upper Arm Contouring

The only thing that is certain in upper arm contouring is that liposuction alone will never be as effective for arm tightening as a brachioplasty procedure. A brachioplasty removes skin and fat while liposuction only removes fat and only achieves a little skin tightening by contracture.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Tail of Spence Removal and Lipo Vs Brachioplasty to Slim and Tighten Arms?

              Localized fatty deposition can be improved with liposuction.  If there is more than mild skin laxity,  the brachioplasty would yield the better result.  A physical exam could help determine the appropriateness of liposuction.  Liposuction results are highly surgeon dependent.  Find a plastic surgeon with ELITE credentials who performs hundreds of liposuction procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.


Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.