One area that is consistently of concern is the upper arm, where there is often a large amount of sagging skin. Sagging skin under the arm is often referred to as “bat wings.” If you are concerned with the amount of sagging skin under the arm, then you may be a candidate for an arm lift, also called a brachioplasty.
An arm lift is a cosmetic procedure that reshapes the profile of the arms to create a slimmer shape. Skin tends to sag as we age. This is because the skin loses its elasticity. The result is skin that is less able to resist the effects of gravity. The procedure involves an incision along the backside of the upper arm, which allows for the excision of redundant skin.
Types of Brachioplasty
There are several arm lift techniques. One determines the proper technique by assessing the amount of skin to excise to achieve the desired result. As a rule, the more skin that is loose, the larger the incision a plastic surgeon needs to make. When there is redundant skin present in the arm, there is often also redundant skin along the arm pit and lateral chest wall. The extension of the incision along the arm pit or lateral chest wall, when necessary to correct the deformity, creates an “L” shaped scar. Cosmetic surgeons call this an “L brachioplasty”. Patients who have lost a massive amount of weight often require an L brachioplasty because the tissue elasticity has been terribly compromised from rapid body volume loss. Thus, skin excess is generally global in nature.
Crescent and L Brachioplasty
In arms that have less skin redundancy, a crescent brachioplasty may be performed. As it sounds, a crescent shaped area of skin is excised in the axilla to tighten the arm. This tightens the arm in only one vector. Contrary to this, the L brachioplasy tightens the arm in two vectors. As a rule, the crescent brachioplasty does not tighten the entire upper arm beyond the mid upper arm. This is because the anchor point for the skin is in the axilla (arm pit). The farther one travels from the anchor point, the less tension one sees. The advantage of this weak reshaping technique is that the plastic surgeon can hide the scar in the armpit. This is in contrast to the L brachioplasty and standard brachioplasty where the incision runs along the inner surface of the arm, ending just shy of the elbow.
In between the L brachioplasty and crescent brachioplasty is the standard arm lift technique which starts in the axilla and ends just proximal to the elbow.
Problems with Brachioplasty
The biggest complaint patients have about brachioplasty is the scar. While the surgeon places the scar in the inner arm, the skin in this area isn’t terribly forgiving when it comes to healing. Thus, the trade-off of better shape for scar must be a satisfactory one for a successful outcome. Two, is poor healing. Because the arm is frequently in motion tension is constantly on the incision. Poor healing may complicate the recovery.
For photos of arm lifts click here.
Dr. Tim Neavin is a board-certified plastic surgeon located in Beverly Hills, California.