Brachioplasty: Tighten and Re-shape the Arms

Do you live with excess skin and fat on your upper arms? Although a sign of ageing, many patients who have lost a significant amount of weight have flabby arms as well. In some instances, that pocket of fat and sagging skin can give a patient’s arms a “wing like” appearance.

Unfortunately, despite eating healthy and exercising diligently, for a lot of weight loss patients the problem doesn’t always go away on its own. The good news is that brachioplasty may be an option for some patients who desire tighter, firmer arms. Arm lift surgery, otherwise known as brachioplasty, is a procedure that reshapes the upper arms by reducing excess skin, and in some cases fat, resulting in smoother skin and better-proportioned contours of the upper arms.

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Who is a brachioplasty for?

The decision to have brachioplasty is a very personal one, and it may not be right for everyone. Prior to making a decision to have the surgery, Dr Beldholm thoroughly listens to his patient’s concerns, carefully assesses their problem area, reviews their overall health and plans the treatment that is suited for them. The ideal candidates for this surgery are:

  • Those who do not smoke
  • Those who are physically healthy and don’t suffer from medical conditions that could hinder healing or increase the risk of complications (Ex: heart problems, diabetes, cancer, etc.)
  • Those whose weight is stable
  • Those with excess soft tissue along the lower arm region
  • Those who have realistic expectations

How is brachioplasty done?

Dr Beldholm first performs VASER liposuction to remove the fat from the arms. This will give patients smaller upper arms and allow the underlying muscle tone to stand out. The loose skin that remains is then removed.

When making the incision, the scar is made as long as needed. Depending on the patient’s preference, the scar can be strategically placed in a number of locations.

As there is no deep dissection performed, there is no need for drains. Using this technique also leads to less bruising and bleeding (2) during the recovery. Because absorbable sutures are used, there is no need for anything to be removed.

What are the benefits of an arm lift?

A patient’s result has a lot to do with the surgeon’s experience. Dr Beldholm has been performing arm lift surgery on his parents for more than a decade. Overall, his patients experience the following results from surgery:

  • The removal of loose skin in the upper underarm area
  • The restoration of firmness and symmetry to the arms
  • A reduction in localised pockets of fat in the upper arm region
  • Less rubbing and discomfort of the upper arms during walks or exercise
  • Arms that appear more contoured and toned

What is the recovery like from an arm lift (brachioplasty)?

Recovery times from full arm lift surgery will vary from individual to individual. Generally there is an overnight stay in hospital. Following surgery, patients are likely to experience some arm pain. However, it can be controlled with pain medication prescribed by Dr Beldholm.

To minimise swelling and fluid build up, patients must wear compression garments for approximately 4-6 weeks. Most patients in non-manual jobs can generally return to work after two weeks. Heavy lifting and vigorous upper body exercise should be avoided for at least 4-6 weeks.

Potential complications from a brachioplasty

Brachioplasty is typically performed as an overnight or day-stay procedure. However, as with all surgery, there is the potential for complications. Most complications tend to be minor (1), and in Dr Beldholm’s experience, if there are issues, most stem from the incision and the healing of the wound.

The procedure will result in scar formation, as with all surgery. With a brachioplasty, the scar is on the inner aspect of the arm, and depending on how much skin is removed, it can extend through the axilla and onto the lateral chest wall, as well as towards the forearm. Scarring is generally pink, but fades to become white in the weeks or months after the operation in most cases. (1). Most patients find that the wound heals in the first few weeks and that the appearance is ultimately acceptable to them. However, abnormal scarring occasionally occurs within the skin and deeper tissues, and these may be unattractive and of a different colour to the surrounding skin.

Postoperative pain will occur in varying degrees, from quite severe to moderate to mild on the first day. It gradually improves over the next few days and is usually well tolerated by patients if they take the painkillers prescribed. Increasing pain unresponsive to painkillers should be brought to the surgeon’s attention as this may indicate that complications are developing. Intermittent mild discomfort or intermittent sharp pains after surgery are common for the first few weeks, as the swelling resolves and the nerves recover. Chronic pain, ranging from mild aching pain to sharp nerve pain can persist for more than one year, but is very rare. Specific complications relating to arm lift surgery may include:

  • Seroma or excessive fluid build-up between the skin and underlying tissue
  • Nerve injuries, including the motor nerves (such as the ulnar nerve) that move the muscles
  • Initial loss of skin sensation in the arm – though usually temporary, in rare cases it can be permanent
  • Visible skin contour irregularities, wrinkles, depressions, and skin pleating, where there is excessive redundant skin
  • Swelling of the forearms and hands, and skin discoloration
  • A sensation of tightness in the arm, which usually subsides over time
  • Infections – either superficial or deep. The infection rate for arm lift surgery is about 3.64% 1 and the problem is usually treatable with antibiotics
  • Bleeding after surgery – requiring emergency treatment to drain accumulated blood or a blood transfusion
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