Brachioplasty (Arm Lift)

Loose, stretched skin in the upper arm follows ageing, genetics, significant weight loss or repeated weight fluctuation. Exercise strengthens the muscle underneath, but it does nothing for skin that has lost its elasticity — which is why well-toned people still present with it.

What brachioplasty does

Brachioplasty tightens loose skin and removes excess fat between the underarm and the elbow, producing an upper arm that is in better proportion with the rest of the limb.

It is indicated where diet and exercise cannot reduce excess fat or tighten loose skin in the upper arm. Where skin elasticity is poor and there are skin folds in the area, surgery is the only option that addresses them.

For patients who have excess arm skin but where the underlying fat is tight and the skin retains reasonable elasticity, brachioplasty combined with liposuction may be the better answer. Liposuction on its own cannot address skin that has lost elasticity.

The operation is performed on both men and women.

What the surgery involves

Brachioplasty is performed under general anaesthesia administered by a certified anaesthesiologist.

The length and pattern of the incision depend on how much excess skin there is and where it sits. Incisions are placed on the inner or posterior surface of the arm so that the scar is as concealed as it can be.

Where looseness is severe the incision may run the length of the inner arm and finish hidden in the axilla or on the side of the chest. Where it is limited, the incision runs only along the hanging area.

Where there are additional pockets of fat, liposuction is performed at the same sitting.

The skin is then drawn back over the underlying tissue and the wound closed with absorbable sutures.

Who it suits

Consultation establishes whether brachioplasty alone, or brachioplasty with liposuction, is the right approach. In general the operation suits:

• People in good health who exercise regularly but cannot achieve the upper arm result they are after
• People who have lost significant weight and held it off for at least six months, but still have excess fat and loose skin in the arms that looks disproportionate to the rest of the body
• People with isolated loose skin on the inner and posterior surface of the arm
• People who are in good shape but whose upper arm skin has lost elasticity with age

Recovery

A pressure garment is worn for fifteen to twenty days to limit fluid collection and control swelling.

A tighter upper arm contour is apparent immediately. Bruising and swelling are normal and settle over the first few weeks.

Routine activity resumes gradually from the first day after surgery. Anything strenuous enough to stretch the incisions is avoided for several weeks, and the arms are not lifted above shoulder level for the first three to four weeks.

Detailed post-operative instructions cover medication, wound care, what to avoid, and the schedule of follow-up visits.

Results are long-lasting. Skin loses some firmness with age, and changes in weight or a pregnancy will alter the appearance of the upper arm again; a stable weight is what preserves the result.