Brachioplasty: The Art of Tightening the Arms
Dr. Neavin has trained under arm lift pioneers Drs. Peter Rubin, and Dennis Hurwitz, at the University of Pittsburgh Medical Center. He has also lectured on buttock augmentation with body lift surgery, and has co-authored several book chapters on brachioplasty, including:
- Hurwitz DJ, Neavin T, Body Contouring of the Arms and Brachioplasty, Handchir Mikrochir Plast Chir 2007; 39; 1-5.
- Hurwitz Dj, Neavin T, “The L-Brachioplasty” for Clinics of Plastic Surgery edited by Al Aly
- Hurwitz DJ, Neavin T, “Brachioplasty in Advances in Aesthetic Surgery” edited by Aston S, Reese T, Theime Medical Publishers, New York
Sometimes called bat wings, hanging skin from the arm is never attractive. What makes this condition so frustrating is that diet and exercise often doesn’t correct the laxity. In fact, hanging arm skin is often caused BY diet and exercise. Rapid weight loss is forgiving in some people. In others, the skin just can’t catch up with the fat loss. If the skin doesn’t retract, saggy skin is the result. Below is the common appearance of “bat wings”.
Arm lift surgery addresses laxity of skin in the upper arm. Brachioplasty is the medical term to describe the surgical excision of these bat wings. Liposuction of the arms is the preferred method to reduce arm girth, but sometimes the problem isn’t too much fat – it is too much skin.
Redundant Skin is the Problem
When it’s a skin issue, an arm lift is the superior solution. The arm lift requires an incision that sometimes extends from the armpit to just before the elbow. Incisions are hidden on the inside of the arm. An arm lift can be done as an outpatient procedure, so patients can go home the same day. Smokers should quit smoking at least four weeks prior to an arm lift because smoking and nicotine can prevent wound healing. In the video below, Dr. Neavin discusses the different types of brachioplasty procedures.
Types of arm lifts
There are several methods to correct arm laxity. In certain individuals with mild to moderate skin laxity, circumferential liposuction alone can not only sculpt the arm but stimulate skin tightening. In others, a staged approach may be the best approach. With this technique, fat is removed via liposuction and the skin is allowed to tighten for up to six months before a skin excision is made to remove any residual laxity. The advantage of a staged skin excision approach is that the scar may be smaller than if the procedure is performed in a single step.
When it comes to skin excision, the rule is that the incision (and residual scarring) is proportionate to the laxity of the tissues. Brachioplasty for mild to moderate skin laxity may be performed via a crescent shaped excision within the armpit. This nicely conceals the scar but will not sufficiently address severe laxity.
For cases of significant skin laxity, incisions must run along the length arm and perhaps even into the armpit or lateral chest wall. L-brachioplasty, as described by Hurwitz and Neavin, has become a popular procedure to not only correct arm laxity, but the bra roll which often accompanies loose arm skin.
The image below illustrates the marking for a modified L-brachioplasty. The incision will extend into the arm pit and down the chest wall. However, it will only extend halfway down the upper arm. Skin is excised between the blue and red lines. Then, points A is sutured to A’.
Unfortunately, there are no lasers or devices other than surgery to address severe skin laxity of the arm with consistently effective and permanent results.
What is recovery like after Arm Lift Surgery?
After surgery, the arm is wrapped for a week or two. Downtime is minimal because this is a surface operation.
If you are adhering to a diet and exercise program, it is wise to wait until you have lost all of the weight you have set as a realistic goal before undergoing surgery. Once you achieve your target weight, it is best to wait a few months to allow some skin to retract before your arm lift. This will ensure the best overall cosmetic outcome.
If laxity is an issue in the arm, it often is an issue in other parts of the body. Because brachioplasty can be performed in about an hour, it is often a good idea to combine the arm lift with other procedures, such as mastopexy, a tummy, tuck, or thigh lifts. Ultimately, combination procedures will reduce costs. However, there is such a thing as doing too much at one time. Procedures like an arm lift require extensive stitching and this takes some time. It is best to keep surgery under eight hours for elective procedures to ensure patient safety. Often, I will bring in another plastic surgeon to reduce time to make the surgery as safe as possible.
An arm lift offers dramatic sculpting of the upper arm, giving you the confidence to wear sleeveless clothing and bathing suits once again. To get more information about this procedure, contact Artisan of Beauty Plastic Surgery at 310‑858‑8811 or text 323‑975‑1287.