Plastic surgeons generally design their surgical procedures to hide the scars as much as possible in an effort to obtain the best aesthetic result. In some cases, however, it is difficult to hide or camouflage them; particularly in procedures where a large amount of skin needs to be removed.
Minimal Arm Lift
With the smallest arm lift procedure, often referred to as an axillary arm lift, only a small amount of skin is removed and the scar can be hidden pretty well in the armpit (axilla). The advantage here is a minimal, well-hidden scar; the downside is that only a small change can be made in the contour of the upper arm. Unfortunately, few patients are good candidates for an axillary arm lift as most have way too much skin that needs to be removed; usually as a result of significant weight loss.
Arm Lift After Massive Weight Loss
Most patients seeking an arm lift procedure have lost a considerable amount of weight and have a large amount of excess skin on their arms. A small arm lift is not going to do much for these patients. A full arm lift removes a considerable amount of excess skin on the inner aspect of the upper arm leaving a scar that extends from the axilla to the elbow. This scar is hidden when the arms are down to the sides of the patients but will show with short sleeves when the arms are elevated.
Chest Arm Lift Extension
Those who have had a tremendous weight loss may need to have even more skin removed so the incisions may extend past the elbow on to the forearm and into the axilla with a transverse incision at the apex of the armpit. Another possibility is extending the incision down the side of the chest in continuity with the arm skin incision; removing excess skin in that area as well. This is known as an “L” brachioplasty. The incision for the lateral chest extension arm lift often runs perpendicular to the incision from a breast lift which may preclude performing the two procedures at the same time.
Patients who have arm lifts generally have extra skin in other areas and wind up having two or more surgical procedures to get rid of it. The most common are tummy tucks, breast lifts and thigh lifts. Frequently, two procedures are done at the same time and, most commonly, patients will have their breasts lift done with a tummy tuck and later combine the arm lift with either a thigh lift or breast implants.
Your surgeon should discuss these options with you prior to surgery so that you can choose the one that fits you the best taking into account how much excess skin you have and where you desire your scars from the surgery to be. In contrast to many advertisements regarding scar creams and lasers, the arm lift scars are permanent scars and despite wild claims by these companies, they are rarely changed significantly with topical procedures. We recommend taping over the incisions for several months to minimize scarring.