An arm lift, or brachioplasty, is a surgical procedure that: reduces excess sagging skin that droops downward, tightens and smoothes the underlying supportive tissue that defines the shape of the upper arm and reduces localised pockets of fat in the upper arm region.
A brachioplasty is a surgical procedure to remove loose skin and excess fat deposits on the upper arm. This can be caused by age, as the upper arm skin becomes loose and flabby, or may simply be a feature of natural fat distribution and surplus arm skin (often caused by weight loss).
Brachioplasty procedures tackle these conditions to leave a tight and smooth skin appearance by using one, or both, of two key surgical techniques; liposuction and skin excision.
There are two aspects to the problem of the upper arm, the relative amount of excess fat and the excess skin. These problems have two surgical solutions, which are often combined. At the two extremes, there are patients with large arms with surplus fat, who are treated very satisfactorily by liposuction. Unobtrusive stab incisions are made in the armpit and on the back of the elbow. We then need a skilled and obsessional surgeon to very carefully remove the fat in a smooth manner from all the way around the arm. There are other adjacent areas that we often treat at the same time, and in particular fat around the shoulder, armpit, adjacent back and so-called tail of the breast. This is fat that bunches up particularly when wearing a bra, below the front of the armpit. In addition, we also carry out liposuction of forearms and make particular note of the fat on the back of the elbow. All of these areas can be treated in the same session.
This liposuction carried out on its own is particularly useful when the skin is still relatively elastic and will therefore be more commonly carried out in younger patients. At the other extreme, we have skinny patients who simply have a lot of loose skin hanging down embarrassingly as ‘Bingo Wings’. Retraction of the skin after liposuction would not be adequate, and in any case, there is little or no fat to remove. In this case, the solution is skin reduction, and can only be carried out by removing a long ellipse of skin all the way from the back of the elbow, along the line between the inside and back of the arm, curving into the armpit. Positioning of the scar to make it the least obvious is important.
The scars themselves take some months to settle in. There are surgeons who offer to tighten the skin with an excision of skin confined to the armpit. The skin then is pulled up towards the armpit like pulling up a sock. Unfortunately, this does not work for the vast majority of patients. The excess skin is around the circumference of the arm and not along the length. In patients who have had extreme weight loss, perhaps after bariatric surgery, there is surplus skin everywhere and the arm reduction can be incorporated into reductions of skin of the back, flank and breast
There are many patients who do not fit into these two groups. They have both excess fat and excess skin. Liposuction alone will not tighten the skin sufficiently. In these cases a combination of liposuction and excision of skin and fat is carried out. Experience and careful planning is required to produce a symmetrical result. We have all seen patients who have had unequal amounts of skin and fat removed with unnatural shaped arms, of unequal size. There are even occasions were patients have required to have skin put back, using skin grafts.
How the operation is performed
Before surgery the surgeon will measure up the arms to assess how much fat and/or skin needs to be removed. The arms are then photographed, with the skin markings, in various positions, front and back. The procedure can be carried out under local anaesthesia, but more usually under our form of general anaesthesia called T.I.V.A. (Total Intravenous Anaesthesia). There is an electroencephalogram called BIS which helps maintain your consciousness so that you are unaware, but only just asleep. You therefore wake up very quickly without sickness, when the procedure is completed.
The arms are bandaged after surgery to reduce bruising and you will feel stiff and mildly uncomfortable as you bend your arms. Most of the sutures used are dissolving to avoid stitch marks, but there may be a few to remove, particularly in the armpit, a week after surgery. Bruising lasts about 3 weeks.
Bleeding - is uncommon, which would cause swelling and pain. Rarely if skin is excised, a haematoma occurs and would need to be surgically released, or aspirated.
Infection - of any surgical wound is possible and usually treated with antibiotics.
Sensation change – temporary numbness after liposuction is normal, and occasionally there will be some permanent numbness and a change in sensation along the stitch line.
Asymmetry – Arms are never quite symmetrical but the risk of any significant asymmetry is greatly reduced by careful surgical technique.
Dissatisfaction – The result of surgery will always be subjective and patients can never know before surgery whether a result, which is considered good by others, including the surgeon, may not be adequate for themselves. The risk of this is reduced by careful discussion with the surgeon pre-operatively, but is never quite eliminated.
ARM LIFT: AT A GLANCE
SURGERY TIME: 1.5-2.5 Hours
ANAESTHESIA: General anaesthesia, which is TIVA at the Cadogan Clinic or localanaesthesia
HOSPITAL STAY: Day Case
DRESSINGS: Full compression garment for 1-2 weeks
SLEEPING POSITION: Whichever position is comfortable
REASONABLY MOBILE: 1 day but the arms will feel stiff
WASHING: Shower and washing arms after 1 week
DRIVING: 2 weeks
EXERCISE INCLUDING GYM: 4-6 weeks
SEXUAL ACTIVITY: Restricted activity after 4-6 weeks
During your consultation, your surgeon will advise you to stop smoking, aspirin or other medication prior to surgery as this can slow down the healing process. He or she will discuss with you when it is suitable to resume these.
It is recommended that you take around two weeks off work depending on the kind of work you do, and for the first few days following your arm lift surgery you will need someone to look after you. Any swelling and bruising is completely normal and will subside within around 10 days. Stitches are removed around 7 days afterwards.
Any risks are the same as with any other surgical procedure that involves a general anaesthetic. Apart from possible bleeding and infection which is not common, there are no specific risks to be concerned about but your surgeon will explain the arm lift procedure to you in detail at your consultation.
In a standard Arm Lift, there will be a scar from the armpit to the elbow inside of the arm but once this has healed after a couple of weeks you are able to have scar minimising treatments to help reduce its appearance effectively.
You may experience bruising and swelling but this is normal and will subside in around 10 days. Most of our arm lift surgery patients are able to resume their usual daily routines within two weeks and it takes about four to six weeks to return to more strenuous physical activities.
If you are in overall good health with a stable weight for at least one year but wish to improve the appearance of so-called ‘bingo wings’ where the upper arms have excessive fat and look out of proportion to the rest of your body.
Following the surgery, you may experience discomfort but most patients report that the pain is very tolerable. Your surgeon can provide painkillers for this and the majority of patients no longer need them a few days after arm surgery.
The Arm Lift surgery is carried out under general anaesthetic. Incisions are carefully made close to the armpit and any excess fat and skin is removed and the skin is tightened. It may be that your expert surgeon chooses to carry out liposuction alongside this procedure for maximum results.
We offer a free, no-obligation 30-60 minute consultation with one of our Patient Advisors. They will work with you to understand your objectives and the results you want to achieve, talk you through the procedure and answer any questions you may have. If you decide that you would like to proceed to the next step and see a surgeon, your Patient Advisor will be happy to arrange this for you. At this point, you will be required to pay a consultation fee.
The next step is for you to meet your chosen surgeon at the Cadogan Clinic. Your surgeon will use this time to make a comprehensive medical assessment of you, your condition, and your expectations before making a recommendation and personalised treatment plan for you. You will then discuss the outcomes you can expect to see and ask any questions.
On the day of your procedure you will be welcomed at the Cadogan Clinic by your Patient Advisor and dedicated nursing staff. Following a brief medical check, you will meet with both your surgeon and anaesthetist to run through the details of your procedure one final time and answer any last questions you may have.
After the procedure, you will recover in the capable hands of our aftercare team. As we are a day-case facility you can expect your recovery to be complete within 2 to 3 hours. If your surgeon is happy with your results, you will be able to be discharged from the Clinic the very same day. In some cases, patients may wish to stay locally in our exclusive partner hotel the day before or after your procedure in order to be close to their surgeon. Talk to us about these options if this is for you.
After Care & Support
Our care and support continues in the days and weeks following your procedure with our complimentary aftercare programme. This comprised of a series of appointments made with your surgeon and nursing team to monitor your progress and recovery. They will also introduce you to several scar minimization techniques and bespoke products to aid your progress. Our team are also on call to answer any questions you have around your surgery at any time you are concerned.
Arm Lift / Arm Reduction Results
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