How is an arm lift performed?
Arm lifts are typically performed under general anesthesia in an outpatient setting.
Prior to surgery, the patient is placed in a sitting position with the arms bent and the elbows pointing out to the sides. The surgeon grasps the skin, pinching it together to determine how much extra is present and marks are made along the inner aspect of the upper arms extending up to the arm pit and often past this point onto the lateral aspect of the chest. In cases where there is a lot of skin to take out, most commonly in massive weight loss patients, the ellipse of skin to be removed will extend beyond the elbow to include the upper forearm.
Following the institution of anesthesia and appropriate prepping and draping, dilute local anesthetic is typically infiltrated into the upper arm to reduce bleeding and to diminish pain after the procedure. This is referred to as the tumescent technique. Liposuction may then be performed to decrease the girth of the upper arm prior to skin removal.
One skin incision is made and the excess skin is undermined using a cautery to not only release the tissue in an effort to reduce the tension on the skin closure, but also to coagulate blood vessels at the same time. This is done until all of the excess skin is released and the surgeon can then determine how much to take out, which is typically done in a stepwise fashion.
After the skin is removed, a careful check for bleeding is performed; the skin edges are brought together and closed with absorbable sutures under the skin. Dr. McMahan used only absorbable sutures so that there are no external stitches to be removed and no scars or permanent marks are made by the sutures. The incision lines are then covered with sterile tapes followed by an antibiotic impregnated gauze and then a wrap of sterile gauze and an elastic wrap.
In larger cases, where there is more bleeding or when a lot of liposuction is performed, a drain may be place prior to the closure and is removed within a few days. The drains tend to reduce swelling and bruising during the recovery period and may also decrease the risk of infection.
Once the initial dressing is removed and any drains are taken out, an elastic garment is applied and is worn on the arms for several weeks. This provides even compression to the area to help reduce swelling and to help the arms heal with a smooth contour.
There is also a mini-arm lift for those who only have a little excess skin on the upper-most aspect of the arms near the armpit. This type of arm lift leaves a much shorter hidden scar in the axilla and can be combined with liposuction at the same time but only provides a limited improvement in the arm as only a small amount of skin is removed.