Arm reduction and lift (brachioplasty)

Even after massive weight loss, patients continue to diet and exercise. Unfortunately, one of the stubborn areas of skin and fat deposit is the upper arm. The upper arm is very difficult to target with exercise and even more difficult to force the skin to shrink wrap around the arm once the fat is gone. Thus, patients are often left with significant fat hanging from the upper arms. This can lead to difficulty finding clothes that fit, being able to exercise, and chronic skin and armpit rashes.  

Sometimes after weight loss, patients may be left with isolated areas of upper arm fat. Dr. Katzen will carefully examine your arms. If you are “young” and your skin has good elastic qualities, liposuction may be the appropriate surgery. It should be stressed that liposuction only removes fat, and the results completely rely on your skin’s ability to shrink wrap around the removed fat.

Incisions: crescent, modified T, longitudinal

The amount and location of the excess arm skin and fat determine where arm incisions are placed. If excess skin and fat are “mild” then a crescent incision may be the best way to treat the area. The incision is placed in the armpit and extends from the front of the armpit to the back of the armpit. A wedge or crescent area of upper arm skin and fat is removed. The resulting scar is “hidden” in the armpit. When your arms are held at your sides (normal arm position), the scars often are barely visible. This technique is best suited for patients who have excess skin and fat in the upper inner portion of the arm.    

If the amount of upper arm skin and fat is “moderate”, then a modified T incision may be the best approach. This incision utilizes the above crescent lift, but goes a step further. The incision under the armpit is still the same, but with the modified T arm lift incision, there is an extension of the incision down the arm. This extension goes from the center of the armpit towards the elbow. This extension allows for more removal of excess arm skin and fat. An individual’s amount of excess skin and fat determines how long this incision needs to be. Typically, this extension measures 3-4 inches. This technique is best suited for patients who have excess skin and fat in the upper half of the arm.

If the amount of upper arm skin and fat is “severe”, then a longitudinal incision may be the best solution. This incision goes from the center of the armpit to the elbow. A crescent incision is not needed. Of all the arm lifts, this technique allows for the most amount of arm skin and fat removal. As with other body areas, an individual’s amount of excess skin and fat determines how long this incision needs to be. This technique is best suited for patients who have excess skin and fat throughout the entire arm from the arm pit to the elbow.

The Consultation

Dr. Katzen will examine your arms and determine which incision would best serve your goals. The proposed incision will be shown and your anticipated results will be shown in the mirror. If you have arm asymmetry or deep arm creases, often these can be corrected during your arm lift/reduction surgery. Depending on the amount of excess arm skin and fat, the presence of rashes and other topical problems, insurance may cover the brachioplasty. Dr. Katzen can review with you the likelihood of insurance approval. During consultation, Dr. Katzen will also review with you the benefits of each type of arm lift/reduction procedure.

The Procedure

Depending on the arm lift /reduction procedure chosen, the procedure takes approximately 2 to 3 hours. Dr. Katzen performs this procedure with a board certified anesthesiologist in a board certified surgery center or hospital. Before the surgery, the arms are measured and markings are placed were the incisions are planned. The arms are then sterilized and draped. Once the patient is completely asleep, incisions are made. Dissection is carried through the arm tissue. Excess arm skin and fat are then removed. The incisions are then meticulously closed with sutures. Typically, you will spend 1 to 2 hours in the recovery room. After the recovery room, you will be allowed to go home. Dr. Katzen will see you several days later and the bandages will be changed. After surgery, your arms will tight and your hands will feel swollen. With time the swelling subsides. When Dr. Katzen feels that your incisions have healed to a certain stage, he will dispense compression garments. These garments are essential for proper arm lift healing. These garments serve to flatten the arm lift scar and minimize arm swelling. Depending on work type, most patients are able to return to work approximately 10 to 14 days after the arm lift procedure.