Liposuction and arm lifts are the two options for surgical correction of upper arm deformities; one focuses on the fat while the other concentrates on the excess skin.
Sometimes, the two are done simultaneously when there is a combination of both excess skin and fat present.
Isolated Fat Removed
Liposuction of the upper arms is limited to patients who have excess fat in that area that is not excessive and also have good skin tone, allowing the skin to ‘snap back’ for a normal contour without leaving sagging excess skin after fat removal. It is typically done as an outpatient under anesthesia. It usually takes only one very small incision just above the elbow so there is virtually no scarring. Liposuction of the upper arms is typically for relatively younger patients who have not lost a lot of weight while still having very good skin tone.
An arm lift, or brachioplasty is generally performed on patients who have lost a considerable amount of weight and have excess skin on their upper arms. Sometimes there is residual excess fat in the area as well and this can be removed with liposuction at the same time as performing an arm lift. Since a lot of skin is removed with a brachioplasty, there is considerably more scarring. The standard scar runs from the elbow to the armpit along the inside of the arm so that it is hidden when the arms are down by the patients’ side. Most patients, however, have enough extra skin that the scar extends past the elbow and either into the axilla in a “T” shaped scar or onto the side of the chest so that it is more shaped like an “L” as it bends from the arms to the sides of the chest.
Both procedures concentrate on the contour of the lower hemisphere of the upper arm as viewed when the arm is extended out 90 degrees from the body. Fat on the outer surface of the arm is much more difficult to remove in a smooth fashion and skin excision in that area would result in severe scarring.
Two Stage Procedure
Occasionally, patients will present with excess fat on the upper arms along with fair, but not great skin elasticity. Often times they will prefer to go through the smaller, less expensive procedure of liposuction alone to see if they will be happy with the result. It is best in this situation to have the mind-set that, if liposuction alone does not provide the best contour, proceeding subsequently with an arm lift may be necessary to achieve the desired outcome.
There is also a less extensive arm lift that places a smaller transverse scar in the armpit making the scar essentially invisible except in a sleeveless shirt with the arms elevated. This procedure is commonly combined with liposuction, however, since only a minimal amount of skin is removed, only a small correction in contour is achieved on the upper-most inner aspect of the arm. Only a minority of patients presenting for arm procedures are actually good candidates for this minimal form of an arm lift.