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 procedures are done simultaneously for a combined effect.
Liposuction of the upper arms is limited to patients who have excess fat in that area which 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. This is typically for relatively younger patients who have not lost a lot of weight. Usually only a very small incision is made just above the elbow that almost disappears upon healing.
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; some of which can be removed with the excess skin and some can be removed with liposuction at the same time as performing the lift. There is a limit, however, as to how much fat can be removed at the same time that the skin removal is performed.
Both liposuction and arm lift 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 contour and skin removal from that area could result in severe scarring.
Occasionally patients will present with excess fat on the upper arms and fair, but not great skin elasticity. Often times they will prefer to go the route of the smaller, cheaper procedure of liposuction alone to see if they will be happy with the outcome. However, it is best if they have the mind-set that, if their skin does not retract to a smooth contour after a satisfactory period on time, they are willing to then undergo the full brachioplasty to achieve the shape and contour that they are looking for.
Unlike a full arm lift where a lot of skin is removed, a mini-arm lift can be done on patients who only need a small amount of skin removed and who do not want visible scars. This much smaller lift only takes out an ellipse of skin in the armpit (axilla) leaving a scar that is only visible when the arm is fully raised. This results in a minimal lift of the upper most portion of the arm only and can be combined with some liposuction; however, if more than just a small amount of liposuction is done and there is not very good elasticity to the skin, there may be too much residual excess skin left that may not be adequately tightened with just a small lift.