Brachioplasty (Arm Lift)

Overview 

Brachioplasty, commonly known as an arm lift, is a surgical procedure aimed at reshaping the upper arm, specifically from the arm to the elbow. It involves the removal of excess skin and tissue to create a smoother appearance. 

This procedure is often sought by individuals who have experienced significant weight gain and subsequent weight loss, which can result in stretched skin with reduced elasticity. Common areas for excess skin include the arms, chin, upper thighs, and lower abdomen. Brachioplasty is a type of body–contouring surgery typically performed after weight–loss surgery, often in conjunction with other body contouring procedures, such as midsection, chin, or inner thigh treatments. 

During the surgery, a cosmetic surgeon makes an incision on the inner or back of the upper arm, removing excess skin and fat. The remaining tissue is then carefully stitched back together to create a smoother arm contour and potentially improve muscle tone. In some cases, additional tissue removal may be performed on the chest’s side, and liposuction may also be used to enhance the overall contour. The surgery is typically performed under general anesthesia.  

Reasons for undergoing the procedure  

Brachioplasty surgery may be a suitable option if you experience sagging or drooping in your upper arms, often characterized by the appearance of excess skin resembling batwings when you raise your arms. This condition can be attributed to various factors: 

• Natural changes in skin elasticity that come with the aging process. 
• Significant weight loss, whether through obesity surgery or other means, while maintaining a healthy lifestyle. 
• Genetic predisposition that leads to sagging skin. 
• The presence of lymphedema.  

Risks 

The risks which may occur from brachioplasty include:  

• Seroma or pooling of fluid  
• Injury to the muscles, blood vessels, or nerves  
• Dehiscence or separation of wound  
• Numbness  
• Unusual scarring   
• Profuse bleeding  
• Infection on the area of surgery  

Before the procedure  

Before considering this operation, it’s essential to consult with your doctor to determine if you’re a suitable candidate. Certain health issues may make the surgery too risky. Additionally, your surgeon will want to ensure that your expectations for the procedure’s outcome are realistic.  

This surgery should not be performed until your weight has stabilized. Losing weight after the surgery could lead to new areas of sagging skin, and gaining a significant amount of weight can harm your already delicate skin, potentially resulting in wide scars and stretch marks. 

If you smoke, you must quit at least a few weeks before the procedure. Smoking can delay your operation and significantly increase the risk of complications. Check with your surgeon about any medications you should stop taking before surgery, including over–the–counter drugs like aspirin. On the day before the procedure, avoid eating or drinking anything after midnight. Also, inform your surgeon of any recent health issues, such as a fever. 

Before the surgery, your surgeon may conduct various tests, including: 

• An electrocardiogram (EKG) to assess your heart’s rhythm. 
• Pulmonary function tests to evaluate your lung function. 
• Standard blood tests to check kidney function, detect anemia, and identify infections. 

Your doctor may provide additional guidance on preparing for the surgery.

During the procedure  

Following a brachioplasty, the steps include: 

• Anesthesia is administered, either general or local with relaxation medication, to ensure pain–free surgery. 
• An anesthesiologist monitors vital signs throughout the procedure. 
• Antibiotics are given to prevent infections. 
• The surgeon makes an incision, typically along the arm’s back or inside, extending from the underarm to the elbow or partly down the chest. 
• Excess skin and fat are removed from the area. 
• The surgeon then reconnects the skin to create a smoother contour. 
• Additional body–contouring procedures may be performed if planned. 
• Dressings are applied to the incisions. 
• Drains may be inserted to prevent fluid buildup during the healing process. 

After the procedure  

After undergoing a brachioplasty procedure, you may wake up with a drainage tube placed beneath your skin to facilitate the removal of fluid from the surgical site. This may cause some discomfort, but you can request pain medication to manage it. You should be able to resume a normal diet when you feel ready. Depending on your individual case, you may need to stay overnight in the hospital, while others can be discharged on the same day. If you’re in the latter group, ensure you have someone available to drive you home and plan for assistance during your initial recovery period, as it won’t be safe for you to drive for several days. Your surgeon will provide specific instructions on how to care for your incisions, which may involve some drainage initially. It’s crucial to promptly report any severe drainage, redness, fever, or sudden onset of symptoms like shortness of breath or chest pain to your surgeon. Following your surgeon’s post–operative guidance diligently is essential for a smooth recovery. 

The results of your brachioplasty will be visible immediately and can be maintained as long as you maintain a stable weight. If you are dissatisfied with the outcome of the surgery, it’s important to have an open discussion with your surgeon. In some cases, additional procedures may be recommended to achieve the best results. Prioritizing communication and adherence to your surgeon’s advice will contribute to a successful recovery and overall satisfaction with the brachioplasty outcome. 

Outcome 

After undergoing brachioplasty surgery, you will observe immediate changes in the appearance and firmness of your upper arms. However, there are some longer–term effects to keep in mind: 

• Swelling and bruising are common in the initial weeks but typically diminish over time. 
• Scars from the procedure may gradually fade but may never completely vanish. 
• Some recurrence of laxity in the arms may occur over time. 
• Natural aging can also lead to sagging of the arms. 

If you encounter any signs of potential complications following brachioplasty, it’s essential to contact your surgeon promptly. These signs may include: 

• Symptoms of a blood clot, such as unusual arm swelling. 
• Dressings soaked in blood or excessive bleeding. 
• Risks of dehydration, like an inability to retain fluids or persistent vomiting. 
• A fever or discharge around the incision, which could indicate infection. 
• Pain that doesn’t respond to prescribed medications. 
• Experiencing shortness of breath or chest pain.
• Noticeable changes in sensation or movement in your arms or hands.