Arm Lift (Brachioplasty)
An Arm Lift, or Brachioplasty, is most commonly performed on persons who have a large amount of redundant skin and fat extending from the armpit to the elbow. Unattractive, sagging upper arms can occur due to aging, genetics, or weight loss. While in mild cases, liposuction alone may be sufficient, more severe cases will require an Arm Lift to obtain sufficient improvement. When the procedure is done at the same time with liposuction, a nice contour of the arm can be achieved.
WHO IS A CANDIDATE?
Any patient with heavy arms and loose skin is a likely candidate. Generally, men and women who are interested in this procedure have either lost a significant amount of weight, resulting in excess or stretched skin, or have a genetic predisposition for excessive skin and fat in this location.
Before Arm Lift Surgery
PRIOR TO SURGERY
For patients considering arm lift surgery, they would start with a consultation. Dr. Delgado asks the patient to discuss his/her concerns about the appearance of the arms during this appointment. In addition, he will explain the variables that will affect the procedure, such as age, size of the arms and condition of the skin. He may use digital photography and computer imaging to facilitate the discussion, as computer imaging can show the location of the incisions and generate a realistic image of the outcome.
The patient will be given a comprehensive booklet that lists instructions for both before and after surgery care; there is detailed information about medications. For example, the booklet explains that all anti-inflammatory products, including aspirin and products that contain aspirin, must be stopped 14 days before and 14 days after surgery, these compounds can interfere with the blood’s ability to clot. However, Tylenol (acetaminophen) is safe to take. But, do not exceed 1 gram over 4 hours or 4 grams per day from all sources since this can cause liver damage.
Included is a listing of homeopathic preparations and vitamins that encourage healing and minimize bruising which the patient can take prior to and after surgery.
Arm Lift Surgery in San Francisco
DAY OF SURGERY
Arm Lift surgery is done with general anesthesia. Only a board-certified in anesthesiologist administers anesthesia at Marin Cosmetic Surgery Center. (See credentials for Randy Gaynor, MD on this website.) The anesthesiologist will call the patient on the night before the scheduled surgery to go over his/her medical history, ask if there are any questions regarding the anesthesia and confirm last minute instructions.
WHAT TO EXPECT
The surgery is usually carried out in a hospital or a private surgery center. In some cases, the patient may be kept overnight to ensure that his/her first post-operative night is as comfortable as possible especially if other surgical procedures are done.
Dr. Delgado performs Arm Lift surgery at his outpatient surgery center, which is fully accredited. Marin Cosmetic Surgery Center (MCSC) is Dr. Delgado’s private surgery center which is located on the campus of Sutter Marin County Community Hospital, in his Marin County office, allowing him to give his patients outstanding medical care, with reassurance and safety with the hospital next door.
A surgical marking pen is used to draw a detailed map on the undersides of the arms before general anesthesia is given. This architectural drawing allows the surgeon to make adjustments that occur in the arms as one moves from lying to sitting. The length of the incision is dependent on the amount of skin that needs to be excised. Incisions usually stop at the elbow, but they can extend from the armpit downward along the upper torso, if necessary.
After general anesthesia is given, a solution of saltwater, lidocaine (a local anesthetic) and epinephrine (a medication that restricts bleeding) is injected into the underarm area. Once this has taken effect, liposuction is performed in the underarm area. An incision is placed in the most inconspicuous location of the inner arm. A long section of skin is excised. The incision is closed in multiple layers to achieve a tight, even closure. After surgery, an elastic sleeve compression garment is put on the arms to control swelling.
After Arm Lift Surgery
After surgery, the patient will be taken to recovery for a few hours. Once the patient is awake, and has the assistance of a family member or friend, he/she can go home. To effectively manage the arm swelling that will occur, the patient should use pillows to keep his/her arms continually elevated above heart level for a week. The patient should maintain this position as much as possible throughout the day and night. The arm compression garment is worn for four to six weeks following surgery to smooth and support the newly contoured skin. It is important that the incision lines are kept clean and well covered with steri-strips until removal of the sutures which is in about ten to fourteen days.
The arms are bruised and swollen for approximately ten to fourteen days following surgery. Patients may experience swelling in the hands as well. Keeping the arms and hands elevated is the best deterrent for this. One can performs light work around the house at one week and start driving a car about this time. Work can be resumed in about 10 to 14 days and exercise can be started in six weeks.
Arm Lift Surgery Risks
Like all surgery, there are risks of bleeding and infection, as well as anesthesia risks. With a highly qualified plastic surgery team and a state-of-the-art surgical facility, these complications are rare.
The outcome is excellent. The only drawback is the scar, which is located on the inside of the arm, but nonetheless, it is a scar that improves as it fades over time. Scarring can be minimized by conscientious application of silicone sheet dressings. These can be applied after the incision lines are completely healed and continued for approximately two months thereafter. This method of scar management encourages flat healing of the incision lines and is very effective in improving the quality of the scars.
The goal is to achieve a thin, smooth contour of the arm, allowing the patient to fit into clothing more easily and comfortably and to have more self-confidence. The procedure has long-lasting results.
Frequently Asked Questions
About Arm Lift Surgery
1. Where is the scar?
The scar runs on the inside of the arm from the elbow to the armpit region. This posterior placement hides the incision very well. The incision may be continued into the underarm and possibly into the upper torso, if extra skin extends into those areas.
2. How long will it take for my scar to heal?
The incision continues to heal for at least 12 months following surgery. During this time, the incision will change from a reddish pink to a lighter pink to nearly natural skin color. There are scar management techniques that can improve the final appearance of the scar. A scar management program is started after the incision has healed for three to four weeks and is continued for a two-month duration.
3. Is liposuction done as well?
Yes, liposuction is always done with an arm lift. The purpose of the liposuction is to reduce the volume of arm fat prior to excising skin.
4. Who is a good candidate for an arm lift?
Patients who have redundant skin with poor skin quality are good candidates. Usually these are patients who have experienced massive weight loss, but they can also be those whose genes dictated excessively bulky arms.
5. How long does the surgery take?
The surgery takes about three to four hours, depending on the amount of skin removal and liposuction required. It is done under a general anesthetic and the post-operative recovery is not significantly painful or uncomfortable.
6. When can I return to normal activities?
Most patients can return to work in seven to ten days, as long as his/her job does not require a lot of physical activity and exertion. A compression garment is usually worn for six weeks following surgery in order to reduce post-operative swelling.
If a patient’s work is physically strenuous, they may not be able to return to work for two to six weeks, depending upon the exact nature of his/her job. Although patients may drive a car approximately five to seven days after surgery, formal exercise regimens should not be resumed for six weeks.
7. Can other procedures be done at the same time?
Yes, other procedures can be done at the same time. Procedures that are often combined include breast lifts, tummy tucks and additional areas of liposuction.
8. What is the cost of an arm lift?
The cost is approximately $6000-$8000, depending on the complexity of the case and the length of time required to complete the surgical procedure.