A common area of concern are the arms. Genetics, sun exposure, weight gain and weight loss may affect the appearance of our upper arms- with weight gain, fullness of the upper arms due to excess fat, especially if the fullness is out of proportion to the rest of the frame, may cause one to avoid short sleeves and sleeveless tops. Significant weight loss can sometimes be even worse- hanging redundant skin of the upper arms is sometimes referred to as “batwings”.
There are three different techniques, or combinations thereof, that I find myself recommending for the upper arms. The simplest is liposuction. Liposuction of the upper arms is a nice procedure for those with fullness of the arm and have maintained good skin tone. This is important as skin with good tone can retract and shrink down after removal of excess fat with liposuction, resulting in a smooth contour to the skin.
Unfortunately, not all skin is perfect. If one has large amounts of extra skin, significant sun damage or stretch marks (striae), the skin may not retract sufficiently following liposuction alone. Brachioplasty refers to techniques where excess skin and fat of the upper arms are removed to make the arms thinner and the skin tighter. These procedures can be performed with liposuction at the same time.
If one has mild amounts of extra skin, a crescent of skin may be removed in the axillary region pulling on the arm skin to tighten it. Often this is performed with liposuction. The resulting scar is placed in the axilla which makes it less visible.
A classic brachioplasty is used when there is more redundant skin of the upper arms. In addition to the crescent of skin removed near the armpit, extra skin is removed down along the arm. This results in a scar that runs the length of the arm from the axilla to the elbow. We hide the scar on the inner back part of the arm to place it more out of sight. The scar does fade with time but it can take up to a year to fully lose color. Liposuction is usually employed to help contour the arm. If one has true “batwings”, this procedure may be the only solution.
A post operative spandex-like garment is worn over the arms during the healing procedure to help with swelling and with skin contraction. One can usually return to work in about 1-2 weeks. Some representative photos are in the Before and After section.