Arm Lift, Arm Reduction, and Liposuction of the Arms
By Mark Richards, MD
Published on August 01, 2006
Many women hide their upper arms, even in the dog days of summer, because they are unwilling to wear sleeveless or short-sleeved shirts. They feel their upper arms are too big and bulky compared to their body, or that their skin hangs or is too loose, which gives their arms an unflattering silhouette.
There are several effective techniques used to reduce the size of the upper arms and to get rid of excess
skin. In the medical profession these procedures are collectively known as brachioplasty. The brachioplasty procedures, which are often used in conjunction with one another, allow plastic surgeons to create a more attractive upper arm without the tradeoff of lengthy post-treatment scars. For those people considered proper candidates after evaluation, these surgical techniques can be used to contour the arms, giving them a more appealing look.
When women have excess fatty tissue of the posterior arm (the part of the upper arm which hangs when the arm is raised), liposuction alone can often offer a satisfactory solution. Plastic surgeons generally use a "pinch test" to determine who is a good candidate for this procedure. If this test shows a moderate thickness to the arm, liposuction treatment may be suitable. The excess fat is removed through several tiny incisions in the armpit and near the elbow. The process of removing the excess fat actually encourages the skin to shrink to a significant extent and to conform to the new arm contour.
For patients who have both excess fatty tissues and loose skin, a combined approach is needed. The extra bulk or fatty tissues are first removed with liposuction, then the loose skin is pulled upward and tucked into an incision in the armpit to smooth the upper arm. This type of ‘arm lift' is somewhat similar to pulling up pantyhose. And while traditional armlift involves an incision on the arm itself, the combined approach involves no incisions on the arm itself, so patients have the freedom to expose their newly shaped arms after treatment.
The Best Candidates for Surgery
The best candidates for surgery are people who have any of the following complaints about the appearance of their upper arms:
- Full, heavy or fatty upper arms
- Flabby upper arms
- Loose or hanging skin of the upper arms
- Arms which are large compared to the rest of the figure
Surgery on the arm can be performed at any age, provided the patient is in reasonably good health. Anyone who is planning on losing a significant amount of weight may want to postpone surgery until after they reach their weight goal, since weight loss can affect your result. Those who smoke need to quit at least four weeks prior to any procedure involving adjustment of the arm skin. The best candidates are those who are mature enough to understand the procedure and have realistic expectations about the results.
All Surgery Carries Some Uncertainty and Risk
Arm liposuction and arm lifts are normally safe and effective operations when performed by a board certified plastic surgeon with experience in the procedure. As with any surgery, good wound healing is expected, although there is always a possibility of complications. You can reduce your risks by closely following your physician's advice both before and after surgery. You can also reduce your risks by refraining from smoking and avoiding smoke exposure both before and after surgery.
Incisions are necessary for both liposuction of the arm and for the modified armlift. These incisions will fade and flatten over time. Your surgeon will discuss reasonable expectations of your incision's appearance based on your healing history and skin type.
Temporary changes in the sensation of the arm skin are normal after surgery, but permanent loss of feeling is very uncommon. Your surgeon will discuss with you what you can expect as far as skin shrinkage and pigmentation changes. This will depend on your skin tone and quality as well as your preoperative proportions.
The human body is normally asymmetrical. It is not possible to create perfect symmetry in the arms through surgery. Your doctor will review what are reasonable expectations as far as symmetry. Swelling after surgery is normal. Most of the swelling should subside in the first couple of weeks after surgery. Infection and bleeding are very uncommon with brachioplasty. Antibiotics are administered during your procedure and a course of antibiotics will be prescribed for your recovery.
Some bruising is normal after surgery. This usually goes away in the first few weeks. To minimize the likelihood of bruising, refrain from taking medications containing aspirin, ibuprofen and vitamin E for at least two weeks prior to surgery. Your surgeon will instruct you on when to resume those medications.
Planning Your Surgery
In your initial consultation, the surgeon will evaluate your health, determine where your fat deposits lie, and carefully assess your skin tone. By taking careful measurement of your current shape and the dimensions of your arms, the surgeon can fashion a treatment plan best suited to your needs. The goal is to decrease the size of the upper arms in order to create better proportions with the rest of the figure. Skin elasticity, or the ability of the skin to shrink to conform to the arm's new contours, is also important and must be evaluated and discussed. Stretch marks in the skin are one signs of skin damage and loss of elasticity. If there is a lot of loose skin or the skin's ability to shrink is less than optimal, your surgeon will recommend an arm lift to tighten the skin.
Your surgeon may suggest treating areas that you had not previously considered. Remember, it is important to view the arms in the context of your entire figure. You do not want shapely arms adjoining bulky areas around the bra straps and back Body contouring surgery is not just fat removal, it is sculpting. The arms need to balance and blend in with the rest of your figure. You may not be satisfied with your result if other parts of your figure are not addressed.
Be frank in discussing your expectations with your surgeon. He or she should be equally frank in describing the procedure in detail and explaining its risks and limitations. Your surgeon should also explain what the recovery will be like, where the surgery will be performed (it should be performed in a hospital), and the type of anesthesia he or she will use (general anesthesia, which is administered by a board certified anesthesiologist).
Don't hesitate to ask your doctor any questions you have, especially those regarding your expectations and concerns about the results.
Preparing for Your Surgery
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding vitamins and other medications. Make sure you purchase any supplies recommended for recovery by your doctor before surgery. Also, be sure to arrange for someone to drive you home after surgery and to help you out for the first day or two.
Arm liposuction and arm lifts usually take two to three hours. The time varies depending on the extent of the procedure.
To begin the procedure, the surgeon makes incisions to remove excess fatty tissues. This is accomplished with hollow tubes of varying sizes called cannulas. One end of the cannula is attached to a machine that creates a strong vacuum. The surgeon manipulates the cannula within the fat layers under the skin, breaking up the fat and suctioning it out. Each area to be suctioned needs to be approached from two different directions.
There are different methods of liposuction. With the tumescent technique, a fluid is introduced into the fat deposits to ease removal and decrease discomfort and bleeding. Power assisted liposuction uses oscillating cannulas that vibrate slightly and quickly remove firm, fibrous fat.
When an armlift is performed, an incision will be made in the armpit along the natural crease where the arm joins the body. This will enable the surgeon to remove excess skin and tighten the remaining skin to conform to the new arm shape. Stitches will be placed in all incisions and a temporary tube may be inserted to drain excess fluid from the surgical site. Compression dressings will be applied to control swelling and to help your skin shrink and heal to fit your new contour.
After Your Surgery
For the first few days after surgery, you will feel swollen, tight and sore. This discomfort and tightness can be controlled with medication. Your doctor will advise you not to allow your arms to hang by your sides. You will need to keep your arms elevated on pillows for the first day or two in order to keep the swelling from drifting into your hands and fingers. You will need to limit arm motion for the first few weeks after surgery, until the incisions are well healed. You should keep your elbows below shoulder level for approximately two weeks after surgery.
Drainage tubes will be removed within a few days and patients are instructed to apply antibiotic ointment around the drain and on the incisions several times per day.
It is also important not to get treated areas wet until instructed to do so. Do not wear deodorant without your doctor's approval.
You will be expected to wear a supportive garment to cover the areas that were treated once the compression wraps are removed. Count on wearing such a garment continuously for three to four weeks. This helps support the skin during healing.
The surface stitches will dissolve once you begin showering and the deeper sutures will dissolve gradually over time.
Getting Back to Normal
Healing is a gradual process. It takes time for the swelling and bruising to subside and for skin sensation to return to normal. It can take up to 3 months for all swelling to disappear.
Patients are encouraged to exercise, as it aids the healing process. Activities such as walking, along with body weights, exercise bikes and treadmills are permissible as soon as seven days after surgery. More vigorous activities such as jogging, aerobics or upper body weights can be resumed approximately four weeks after treatment.
Your incisions will be noticeable immediately following surgery but they will gradually fade and flatten for up to a year after surgery. If you had skin tightening, you will also have puckering around the armpit incision after surgery. This will smooth out over a month or two.
Your skin will also be firm and numb at the outset. It will soften and normal sensation will return gradually.
Your New Look
Both liposuction of the arms and the arm lift procedure produce excellent results for patients with disproportionate arms or arms with loose skin. Patients typically lose several inches from the upper arm and enjoy new freedom to wear clothing that is short sleeved or sleeveless.
Frequently Asked Questions
Q: How many inches can my arms be reduced?
A: This depends on your proportions. The goal is to place the arms in proportion with the rest of the figure. Patients have enjoyed reductions at the mid-arm (usually the largest portion of the upper arm) ranging from 2 inches to 5 inches.
Q: Will I really be able to wear sleeveless clothes if an arm lift is performed?
A: Yes, you will. The incision placed in the armpit to tighten the skin typically heals very well and does not inhibit patients from enjoying the results of their surgery. It takes a full year for an incision to proceed through its maturation process. During that time, it will fade and flatten and blend in with the adjoining skin.
Q: Can I have arm surgery at the same time as liposuction on other parts of my body?
A: After deciding whether there are any medical reasons that preclude you from combining arm reduction surgery or arm lift with other procedures, your surgeon will sit down and discuss the options with you. Brachioplasty is commonly performed at the same time as liposuction of the trunk, breast reduction, etc.
Q: Is the recovery painful?
A: The arms feel tight and heavy the first few days after surgery because of swelling. These sensations diminish quickly. Most patients take four or five days off for their recovery, unless their job requires extensive use of the arms for lifting and extending.
Q: How soon will I see my results?
A: Your arms will be considerably smaller immediately after surgery, even though they are swollen. You will appreciate your final results approximately two to three months after surgery, when the swelling has disappeared.
Q: What is the cost of surgery?
A: The cost of surgery varies based on the extent and the length of the procedure. The cost of surgery will include anesthesia and facility fee costs, supply costs, the surgeon's fee, and all follow-up visits. Remember you are purchasing a surgeon's skill, expertise and judgment and his ability to surgically realize your goals. Every surgeon defines a procedure differently. Cost should not be the sole or defining factor in your decision making.