Dear ThinIn13, When it comes to brachioplasty, the placement of the incision is indeed crucial, both for achieving optimal aesthetic results and for ensuring a smooth recovery with minimal complications. From an aesthetic standpoint, I personally prefer the incision on the inseam of the arm. This placement helps in avoiding a highly visible scar, especially when the arms are by the side or during most common daily activities. The inseam location typically offers a more concealed scar, which can be a priority for many patients. Your surgeon's preference for a posterior incision might be based on their experience or specific technical considerations. It's true that every incision placement has its own set of advantages and potential challenges. The posterior placement might offer certain benefits in terms of skin tightening or reduced complications in some cases. It's essential to have an open dialogue with your surgeon. Discuss your concerns about scarring and understand the rationale behind their preferred approach. Express your preference for an incision on the inseam, and together you can weigh the pros and cons of each approach to determine the best course of action for your specific needs and desires. Remember, the goal is to achieve a result that not only improves arm contour but also ensures that you're comfortable and confident with the appearance of the scars. Best wishes for a successful procedure and a satisfying outcome. Sincerely, Dr. Katzen