‘Bat wings’ is the derogatory term in which women refer to loose, sagging arm skin. Arm lift, also known as brachioplasty, is a St. Louis cosmetic surgery procedure designed to make the arm smaller and more firm by removing fat along with the loose, sagging arm skin. Like other lift procedures, the trade off for a smaller, more firm arm is a scar placed on the inside of the arm.
With more and more patients losing massive amounts of weight through either bariatric surgery or lifestyle changes, arm lifts have been performed more frequently over the past 5 years.
Arm lifts performed at Dr. Jones’ St. Louis cosmetic surgery practice will make the arm circumference smaller and the remaining tissues more firm. Patients report being more comfortable exposing their arms and wearing short sleeve garments again.
Having an arm lift is a very personal decision, and we want to make sure all of your options are explored and your questions and concerns addressed. The consultation will begin with a complete medical history and exam. You should tell us if you have any history of arm, breast, or lymph node surgery. If you are planning to lose an additional significant amount of weight or you may want to become pregnant in the future, you should discuss this with Dr. Jones. You will be asked about the changes you seek, and your exercise and dietary habits. This will help us understand your expectations and determine a plan that best addresses your expectations. Click here to Request Your Consultation at Genesis Cosmetic Surgery and Laser Center.
Good candidates for arm lift are patients who have loose, sagging arm skin and are willing to accept the scar on the inside of the arm. Arm lift is most commonly recommended for those who have lost a lot of weight or simply have loose, sagging arm skin as an inherited feature. You may be a good candidate for brachioplasty if you have the following:
The examination will evaluate the size and shape of your arms, upper chest, and breasts and the quality of your skin, any scars, and the condition of your arm muscles. Other treatment options available will be discussed. You can see photos of recent patients before and after surgery. Patient references are available upon request. The estimated costs of the treatment will be explained. Photographs will be taken for your medical record.
Other issues that will be discussed include:
The incision used for an arm lift produces a permanent, noticeable scar along the inside of the arm. In patients who have had massive weight loss, the incision may even extend into the axilla (arm pit) and onto the side of the chest. The scar on the arm takes more time to fade and flatten compared to incisions on other areas of the body. We take a proactive role to assist in the maturation and fading of the scar.
Every patient has a different tolerance for discomfort. Our aim is to make your surgery and recovery as pleasant as possible. We use a combination of medications to manage postoperative pain. Compression garments are worn for 4-6 weeks after surgery and help reduce swelling and discomfort and facilitate a better scar.
An arm lift is considered cosmetic surgery, and health insurance does not cover any of the costs of the surgery. You will be provided with an estimate that includes the surgeon’s fee, the hospital and anesthesia charges, and any additional anticipated expenses for supplies. Included in your estimate will be a cosmetic surgery insurance policy to cover additional hospital costs in the unusual event in which a medical complication arises in the first 30 days after surgery that is not covered by your own medical insurance policy.
Patients who undergo an arm lift are generally very pleased to have their new arm shape. However, as with any surgical procedure, there are potential risks from anesthesia, bleeding or infection. Fortunately, none of these are very frequent complications. The following are other potential risks of an arm lift:
Lymphocele–Within the skin and fat layer of the arm, there are small lymph vessels that carry lymphatic fluid from the hands to the axilla lymph nodes. When an arm lift procedure is performed, the lymph vessels are opened and leak lymph until they reseal in the postop period. Occasionally, this lymph fluid is not absorbed by the tissues and removal of the lymph fluid is performed in the office via a needle until the vessels reseal.
Scars–Arm lift procedures involve long incisions. Some people make inconspicuous scars while others make more prominent scars. Occasionally, especially in people of color, the scars can be raised and painful; these are known as keloids or hypertrophic scars. There is no way to know if you are one of those people unless you’ve had a past history of this occurring. However, there are several ways to intervene to help prevent and treat prominent scars if they occur.
Unevenness–The goal of an arm lift is to remove the excessive skin and fat and create a smaller arm with a smooth shape. You may not obtain a perfect contour after the initial procedure. ‘Touch-up’ procedures are occasionally needed and are an option if necessary. This ‘touch-up’ can be with liposuction in St. Louis or additional remove of skin.
Delayed Healing–Patients who smoke or have diabetes have a higher chance of slow wound healing. You should stop smoking six weeks before the procedure and 6 weeks after the procedure. Arm lifts require a lengthy incision , and, seldomly, an area of the incision may separate requiring additional placement of sutures.
Lipoplasty– If you have good skin elasticity, liposuction is a reasonable option to reduce the size of the arm. But unfortunately, the arm is predisposed to sagging skin because it has fewer attachments to the deeper tissues. Liposuction can remove stubborn, excess fat, but it does not address the issue of loose skin. When loose skin or cellulite is a significant concern, you should consider a lift or tuck procedure that removes the excess fat as well as lax, redundant skin. A lift procedure has a greater capacity to create smoother, tighter skin. Often both liposuction and an arm lift are performed together.
Change your lifestyle habits — Proper nutrition along with regular exercise should be part of your postoperative plan. However, it’s important to recognize that exercise can increase the size of the arm muscles, but cannot tighten loose, sagging skin. Loose skin requires a lift or tuck procedure.
Lose Weight–Losing weight will change your body shape, but it does not allow you to contour areas where stubborn fat and skin exist in excess. Loose, sagging skin or skin with stretch marks has to be removed to achieve firm, tightened skin. Liposuction, and lift procedures have the ability to permanently eliminate excess fat at specific locations that are resistant to diet and exercise.
Our goal at Genesis is to make your surgical experience as easy and comfortable for you as possible. You will be asked to stop smoking and avoid certain vitamins and drugs that can cause bleeding, such as aspirin, estrogen, ibuprofen and vitamin E. Additional preoperative instructions and prescriptions to be used postoperatively will be provided. For convenience, we recommend that you have your prescriptions filled several days prior to the procedure. Arm lifts are usually performed as an outpatient procedure unless it is combined with other cosmetic procedures.
Dr. Jones will see you the day before the procedure and place ink marks on the arm skin. General anesthesia is used. Antibiotics will be administered at the time of surgery. The procedure takes 3-6 hours, depending on your size and other procedures being performed. Liposuction and breast surgery are commonly combined with this procedure.
Liposuction is performed initially, followed by the arm lift. The incision is placed on the inside of the arm and can extend into the axilla if a large amount of skin is present. Once the excess fat and skin are removed, a drain is placed on each side under the skin, and the incision closed with several layers of dissolvable stitches. At the end, a gauze dressing is placed over the incisions. Following surgery, you will be taken to the recovery area where you will continue to be closely monitored. Pain medications are administered to keep you comfortable. Once you are fully recovered, you will be discharged to home. A friend or family member should plan on staying with you for the next several hours. Your arms will be in bandages, and you will need to keep them elevated as much as possible for the first 3 days until the swelling starts to subside.
The day after surgery you will be very sore. Your arms will be swollen and bruised. You will have prescribed pain medication, and your need for this will become less and less over two weeks. Start your prescribed medicines and supplements the first day after surgery. The second day after surgery, you may start ibuprofen, 600mg every 6-8 hours. You will be seen in the office within the first week to have the drains removed. Repeat visits are routinely scheduled at weeks two and six, six months and one year.
The day after surgery you may take a shower if you wish. The incisions will be covered with tape strips. These should be left in place until they are removed in the office. Once the drains are remove, which can be anywhere from day 4 to day 7, you will be asked to wear a compression garment 24/7 for the next 4-6 weeks to aid in comfort and to facilitate resolution of the swelling.
You can expect to be sore for several weeks. Heavy lifting and activities that require extensive use of the arms should be avoided for six weeks. You may start to walk immediately after the procedure and increase this as tolerated. Rigorous aerobics or jogging may be resumed after 4-6 weeks. You may resume sexual activity in a few days. You may return to work 10 days after surgery at the earliest. Swelling and bruising will gradually resolve over several weeks. The scars may be red or pink for several months, but should gradually improve. Most swelling resolves in six to twelve weeks, but occasionally swelling can persist for up to six months, and it may take this long to see the final results. It is not uncommon to have numbness of the overlying skin or intermittent, shooting pains. Both of these gradually resolve completely within a few months.
The results of an arm lift are dramatic. You have smaller arms with marked improvement in arm firmness. You feel better about your arm shape, and this is reflected in your attitude, behavior, and clothing selection.
An arm lift does not stop aging or correct the lifestyle habits that contributed to your preoperative arm shape. We strongly recommend you have a lifestyle checkup to determine a nutrition and exercise plan that will lead to a long-lasting result and better health.