Patients who undergo arm lift surgery do so because of all the excess skin that they are left with after massive weight loss as a result of surgery or extensive diet and exercise. Others may seek this aesthetic arm surgery simply because of genetics and age.
Some patients lose a significant amount of weight initially and then their weight plateaus for a period of time following bariatric surgery and, more commonly, with those who lose their weight ‘naturally.’ If they choose to have an arm lift (brachioplasty) at this time, it is possible to have an issue with sagging again after they go through another phase of significant weight loss. Rarely, however, is the looseness of the skin and soft tissue sagging as bad as it was prior to their initial procedure.
Natural Skin Relaxation
Many aesthetic procedures in plastic surgery involve pulling the skin taught while removing the excess including arm lifts, thigh lifts, breast lifts, tummy tucks and facelifts. In each case, the skin will not stay as tight as it was pulled at the time of surgery because of the natural tendency of the skin to relax and grow to eliminate the tightness much like a women grows excess skin on her abdomen during pregnancy. This tends to happen more in patients who have lost elasticity in their skin as evidenced by stretch marks and gets worse as we age.
In these cases, it is possible for have a second arm lift surgery if the sagging after the second period of weight loss is significant enough. Although scarring from the initial procedure will be present and can make the surgery a little more difficult, in general considerably less skin is removed during the second procedure than was taken out the first time and the recovery is generally easier or no different. The second procedure typically will not include liposuction that may have been used with the first procedure, which would also tend to make the second surgery less extensive.
Timing of Surgery
As arm lift surgery is a significant procedure that is not inexpensive, most patients do not want to consider having it done more than once. For this reason, it is best to wait until you have reached your weight loss goal or are at least getting close, within 10-15 pounds, to have an arm lift done. As you cannot control where you lose your weight, it is possible for those who preferentially lose their weight in their arms to have their brachioplasty when they still have excess fat to lose elsewhere as additional weight loss will not have much effect on their upper arms.
My Repeat Brachioplasty Experience
So far, I have only have two patients have an initial arm lift and then go on to lose more weight and have enough sagging skin to undergo a second arm procedure. Both were very happy with their initial surgery and remain thrilled after their second arm lift.