What's the Best Procedure for Wrinkled Aging Arms?

Question

I'm 70. My arms have protruding veins, completely wrinkled, age spots. But the worst part is the inside of my forearms. The skin sags terribly with completely crepey skin. I want to cry whenever I look at them. There must be something that can reverse all this. And of course I have saggy upper arms. Sorry, I don't know how to upload pictures yet.

Paul F. Vanek Jr, MD · Answer

Many people in your age group (because of sun damage, genetic predisposition and other medical problems) have problems with their upper arms and forearms. The problem of the forearm laxity is a vexing one for the patient as well as their treating plastic surgeon. I strongly council you to consider doing nothing surgical for the severe laxity of the forearm, because the trade-off of scarring and contour improvements are not as good for your upper arms. Scar positioning is a challenge in forearm laxity. Also forearm laxity procedures are more likely to result in sensory and hand function problems postoperatively. In the forearm, the best technology I've seen for non-operative improvement for laxity is SkinTyte™. One treatment a week for 6 weeks will make a dramatic improvement. You may need some maintenance treatments throughout the year as well to maintain your improved contour.

	Plastic surgery is the trade-off between nearly imperceptible scarring and contour improvement. Extreme laxity of the upper arm can be tremendously corrected with the surgical technique called brachioplasty or arm lift. Brachioplasty surgery takes about 2-3 hours depending on the patient's size. Patients who have very thick upper arms, may benefit from simultaneous Vaser Liposuction, while at the same time removing the excess skin with the brachioplasty. That would be decided upon in your consultation, depending upon your goals. Most patients do not require post-operative compression garments after their surgery. The incision is a woven suture with almost no outside suturing. I typically do not require drains to be placed for this procedure. Many patients benefit from postoperative massage therapy to soften the operative tissues and desensitize the incision. Persistent arm swelling is rare. Patients can resume normal exercise and activity in 2-3 weeks. I allow my patients to shower the next day. Usually my patients are fine to drive a vehicle 4-5 days after surgery.

	Representative photos with great results are available on my website for your viewing.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding wrinkly forearm and upper arm skin.  It is difficult to answer accurately your question without pictures, but I will try my best.  
It sounds like you have extra forearms and upper arms skin with minimal fat.  This is common with normal aging.  Unfortunately, as we age, we all lose skin elasticity. If you had just excess arm and forearm fat and had good skin elasticity, I would suggest forearm and arm liposuction.  Unfortunately, due to your loss of skin elasticity, absence of forearm and upper fat, and presence of excess arm skin, I would suggest skin excision. 
Due to the presence of forearm and upper arm skin, I would suggest a combined procedure addressing both the arms and forearms.   The procedure would remove skin from the upper arm and the forearm.  Depending on physical examination, the incision would extend from the armpit to the mid-forearm or the wrist.  
Good luck with your quest for skinnier forearms and arms.  
If you have any questions, please do not hesitate to contact my office.  
Sincerely, Dr. Katzen

Michael Baumholtz, MD, FACS · Answer

Hello!! Thanks for the question! Loose hanging skin - especially in the arms following weight loss or just age related changes - is a fairly common concern.Let's break the concerns down into the following catagoriesCONTOUR and SKIN POSITION: surgery - brachioplasty to address loose, excess skinFAT?: liposuctionSKIN QUALITY: chemical peel, retin-A, micro needling, etc. Seek out a board certified member of ASPS / ASAPS for your consultation and good luck!

Richard Zienowicz, MD · Answer

The best thing to do would be to consult with a board certified plastic surgeon in person who can review your medical history and work with your specific situation.There are some non invasive possibilities like injectables that can make minor improvements when administered by a skilled experienced doctor. An upper arm skin removal surgery is a much more commonly practiced procedure, and could definitely help with improving the shape and appearance of your arm.

Richard J. Bruneteau, MD · Answer

A large number of treatment options are available to treat aesthetic deformities of the arm. The specific option chosen will depend upon the patient's anatomic findings and aesthetic goals. It's important to remember that no two patients are ever exactly alike and for this reason, procedures need to be tailored to meet their specific needs.Although your history is helpful, it's virtually impossible to make a specific recommendation without pictures or a physical examination. Based on the available information, your biggest concern is loose saggy skin on the insides of your arms. This problem usually always requires removal of the excess skin with a procedure known as a brachioplasty. The procedure involves a trade-off between excess skin and scarring along the inner aspect of the arm. This approach may require secondary maneuvers to address changes in your skin because of solar damage.If you're considering treatment of your inner arms, it's appropriate to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plant that addresses your anatomic findings and achieves your aesthetic goals.

David Stoker, MD · Answer

Your best option is to tighten the skin with some type of arm lift.  Definitely consult with an expert in the field to understand your best options.  The good news is that scars tend to look great in older patients.

Larry S. Nichter, MD, MS, FACS · Answer

How to Treat Aging Arms
	There are several different options that may help  but all to a degree. An exam would be necessary. Prescription strength skin lighteners and or certain lasers will help with the sunspots as well as using sunscreen daily. Their are procedures like RF, radio frequency that may help but only a  small amount in my experience. See a dermatologist or plastic surgeon for further advice.

Kenneth Hughes, MD · Answer

It is quite possible that an arm lift will be a beneficial procedure for you based upon your description. An exam or pictures will be necessary to determine the best procedure choice. Find a plastic surgeon with ELITE credentials who performs hundreds of body contouring 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

Justin Perron, MBBS, FRACS · Answer

Skin changes occur all over our bodies with age. This includes a change in skin quality, loss of skin strength, and resultant ptosis, or 'sag'. The redundancy of the skin that is present, can be unsightly.
There are numerous ways to treat this, and surgery isn't always the answer. Some non-surgical treatments such as RF-needling can be effective in reducing the appearance. 
A large number of treatment options are available. Your options will depend upon your anatomy and aesthetic goals. Procedures need to be tailored to meet your specific needs, goals and anatomy. 
Make sure you seek out all options before deciding on whats best for you
Cheers
Justin Perron

Scott Chapin, MD, FACS · Answer

There are a
few different procedures that would be able address all of your cosmetic
concerns on your upper arms.  First, an
arm lift, medically known as brachioplasty, would be the best option correct
lose and sagging skin in the arms. The skin removal could be extended to your
forearms to remove the excess skin there as well.   Laser
treatments and peels would enhance the texture of the skin by targeting the
wrinkles and sunspots.  To reduce the
appearance of veins in the arms you may want to consider both sclerotherapy or
laser vein removal.  I would recommend
scheduling a consultation with a board certified plastic surgeon to devise a
plan that would tackle all of your concerns.

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