Women and men who have loose upper arm skin and fat that is concentrated in the upper arm can benefit from excisional arm lipectomy (brachialplasty). Sometimes these conditions are inherited. In other instances, substantial weight loss may cause the upper arm skin to become flaccid. Arm lifting also can tighten muscles that have been separated and weakened by age, weight loss or gain and pregnancy. The procedure may somewhat improve the appearance of stretch marks, especially those located in the upper arm.
You may be a good candidate for excisional arm lipectomy if you have one or more of the following conditions:
If you plan to become pregnant or lose weight in the future, you should discuss this with your plastic surgeon. Scarring from previous arm surgery may limit the results of your excisional arm lipectomy.
During the consultation, you will be asked about the results you would like to achieve from upper arm lift surgery. This will help your surgeon to understand your expectations and determine whether they realistically can be achieved.
How will my plastic surgeon evaluate me for upper arm lift surgery?
Your plastic surgeon may examine your upper arm areas while you are standing as well as lying down. Your skin tone and the degree of loose skin in these regions will be assessed. Your surgeon also will evaluate the amount of excess fat in your chest, upper back and upper arm areas and the condition of your arm muscles.
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, pregnancies, previous surgeries and medications that you currently take. It is important for you to provide complete information.
Will my insurance help cover the cost of surgery?
Upper arm lift surgery, as an aesthetic (cosmetic) procedure, generally is not covered by insurance. Insurance reimbursement may be available for that portion of the procedure that is not cosmetic. Many factors determine your eligibility for coverage, including the specific terms of your insurance policy. A letter of predetermination may be required by your insurance company prior to surgery. Your plastic surgeon or a staff member in your surgeon's office will discuss these matters with you.
Individual factors and personal preferences will determine the specific technique selected to smoothen and flatten your arms.
Generally, a T or Y incision is placed just within your armpit.
To tighten and lift the arm muscle, the surgeon brings loose underlying tissue and muscle together with sutures.
Upper arm skin is pulled upward, and the excess is removed. The arm is lifted to a more youthful and higher position.
Where are the incisions placed?
Generally, a T or Y incision is placed just within the armpit. The length of the incision depends largely on the amount of skin to be removed. The contour of this incision will vary somewhat according to the structure of your armpits and the style of bras that you prefer. Your plastic surgeon will try to keep the incision within your armpit, but this may not always be possible.
Skin of the upper arm that contains stretch marks may be removed as well. Any remaining stretch marks may be somewhat flattened and improved, but you should not expect a dramatic change in their appearance.
The procedure may include tightening of the underlying arm muscleusing sutures
WWhat are some variations to the common excisional arm lipectomy technique?
There are many variations both to the design of the incisions and the technique itself. When the amount of loose skin is minimal, a short horizontal incision is all that is necessary. This procedure is called a partial, or "mini," excisional arm lipectomy.
Sometimes liposuction may be used alone, or in conjunction with excisional arm lipectomy, to remove upper arm fat and tighten arm muscle.
Your plastic surgeon will discuss with you the particular method that he or she recommends for achieving the best result in your particular case.
Fortunately, significant complications from excisional arm lipectomy are infrequent. Every year, many thousands of people undergo successful aesthetic surgery of the arms, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and risks.
I understand that every surgical procedure has risks, but how will I learn more so that I can make an informed decision?
The subject of risks and potential complications of surgery is best discussed on a personal basis between you and your plastic surgeon, or with a staff member in your surgeon's office.
Some of the potential complications that may be discussed with you include bleeding, infection and reactions to anesthesia. Tissue loss along portions of the horizontal incision is a possibility when the excisional arm lipectomy is very extensive. This complication, which delays healing and prolongs recovery, is more common in patients who smoke or have medical conditions such as diabetes. Revisionary surgery is sometimes helpful in certain instances where incisions may have healed poorly.
Following surgery, occasionally, fluid may accumulate under the skin. Removal of this serum is a painless process but may require several visits to the plastic surgeon's office.
You can help to lessen certain risks by following the advice and instructions of your plastic surgeon, both before and after excisional arm lipectomy surgery.
The goal of your plastic surgeon and the entire staff is to make your brachioplasty surgical experience as easy and comfortable for you as possible.
If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Your surgeon will provide you with additional preoperative instructions.
Brachioplasty may be performed on an outpatient basis. If this is the case, be sure to arrange for someone to drive you home after surgery and to stay with you for at least the next day or two. When brachioplasty is performed in conjunction with other procedures such an breast lift, a short hospitalization may be required.
Your excisional arm lMedications are administered for your comfort during the surgical procedure. Often, a general anesthetic is administered, so that you will be asleep throughout the procedure. Brachioplasty is usually not performed using local anesthesia and intravenous sedation. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Gauze or other dressings may be applied to your back and covered with tape or an elastic bandage.
You may be permitted to go home after a few hours, unless you and your plastic surgeon have determined that you will stay in the hospital or surgical facility overnight.
The day after surgery, you will be encouraged to get out of bed for short walks to promote blood circulation. Although you may not be able to stand up completely straight, it is best if you do not sit for long periods of time during the first several days. Straining, bending and lifting must be avoided, since these activities might cause increased swelling or even bleeding. You may be instructed to sleep on your back with a pillow under your knees.
Any surgical drains probably will be removed within a week following surgery, at which time your dressings may also be changed or removed. Depending on the excisional arm lipectomy technique used, you may be instructed to wear a support garment for several weeks. Generally, stitches will be removed in stages over a period of approximately 3-4 days.
You will notice swelling and bruising, which is to be expected. The bruising and much of the swelling will disappear over a period of weeks. However, it may be months before all swelling subsides and you see the final result of your brachioplasty. You may also notice some numbness over portions of the back and buttock area, and this may persist for several months. Incisions will initially be red or pink in color. They will remain this way for many months following surgery and may even appear to worsen before they finally begin to fade.
It is important to realize that the amount of time it takes for recovery varies greatly among individuals. Depending on the extent of your brachioplasty and your general physical condition, you may be able to return to non-strenuous work anywhere from one to three weeks after surgery. In many instances, you can resume most of your normal activities, including some form of mild exercise, after a few weeks. You may continue to experience some mild, periodic discomfort and swelling during this time, but such feelings are normal. Severe pain should be reported to your doctor.
Any sexual activity should be avoided for a minimum of two weeks, and your plastic surgeon may advise you to wait longer.
Excisional arm lipectomy will enhance your body contour by making your upper arm muscle firmer and flatter and your buttocks lifted and more youthful in contour. You may find that you feel more comfortable in your clothing and are more confident about your appearance.
The incisions from the procedure will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible. In some instances, they will eventually be only faint lines. Certain individuals may have incision lines that are more noticeable. Fortunately, the incisions for your upper arm muscle surgery are usually in locations concealed by most bathing suits and undergarments.
Unless you gain or lose a significant amount of weight or become pregnant, your upper arm muscle should remain firmer and flatter for many years. However, gravity and the effects of aging will eventually take their toll. If, after a period of years, you again become dissatisfied with the appearance of your arms, you may choose to undergo a second procedure to restore a more youthful body contour.
The results of your arm lift procedure can be easily maintained with a healthy lifestyle, but the use of certain clinical skin care products can help sustain your results. Dr. Speron recommends neaclear Liquid Oxygen Firming Body Lotion, and neaclearplus Liquid Oxygen Rejuvenating Body Scrub. To reduce the appearance of post surgical scars, he also recommends neaclearplus Liquid Oxygen Scar Advantage.
You will return to your plastic surgeon's office for follow-up care at prescribed intervals, at which time your progress will be evaluated. Your surgeon will encourage you to schedule routine follow-up evaluations at the frequency recommended for your age group and the procedure performed.
Please remember that the relationship with your plastic surgeon does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact your surgeon.
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