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Posts Tagged ‘arm liposuction’

The Popularity of Excisional and Non-Excisional Armlifts

Friday, May 3rd, 2013

 

One of the more noteworthy items in the recent release of the annual 2012 statistics report from the American Society of Plastic Surgeons was in the number of armlifts that were performed. The greatest surge in all the body contouring procedures were arm lifts or brachioplasties with over 15,000 performed last year. While that pales in comparison to the millions of cosmetic surgeries performed during the year, this number represents a greater than a 4,000% increase in surgical arm reshaping since 2000 when just a few hundred were reported done.

Why this dramatic increase in armlift surgery? There are a variety of reasons which include new technologies and techniques to treat heavy and bigger upper arms as well as a societal trend towards more shapely upper arms. But a major factor has been the concomitant number of people who have undergo large amounts of weight loss as a result of bariatric surgery and other weight loss methods. The flappy arms that result from extreme weight loss can not be treated by any other method than surgery and the arms are always on the top three concerns of these patients.

The influence of weight loss on the rise of armlifts is reflected in the over 6,000 armlifts that were performed specifically after masssive weight loss, representing 42% of all armlifts done in 2012. The elasticity of arm skin between men and women is known to be different as very few  men ever get armlifts. Despite men who undergo large amounts of weight loss, they very rarely end up with flappy arms or ‘bat wings’. It is so uncommon that I in my Indianapolis plastic surgery practice have never even seen a weight loss male complain about their upper arms. This is corroborated by the scant few male armlifts reports with just over 300 done, representing a meager 0.02% of all armlifts done. The typical armlift patients is a female between the ages of 40 and 54.

Since nearly 60% of armlifts are done in non-weight loss patients, it is clear that there is a strong societal and fashion influence as well. While the female who is working out and getting their body toned may not be getting their desired result in their arms, the historic concept of a surgical armlift and its scar is not a worthwhile trade-off. The aesthetic standards of most more normal weight females is obviously quite different from that of the massive weight loss patient. And while improved suturing/wound closure techniques and scar treatments are available, it is just not a problem that most women want to acquire.

But the full or thick upper armed woman in the past who was not a good candidate for an armlift (brachioplasty) may now consider a variety of liposuction treatment methods. Upper arm fat can be removed using traditional, laser-assisted (Smartlipo) or power-assisted liposuction, to name a few, or even some non-surgical methods such as Cool Sculpting or Exilis. While none of these options will ever work as well as an armlift, they all avoid the need to end up with a long scar. And for the more normal weight female, some arm shape improvement is better even if it is not a dramatic circumferential reduction.

The coalescing of better methods of fat removal and the ability to create some degree of skin tightening, all with no to minimal scarring, has been a major impetus for the exponential increase in arm reshaping procedures. The concept of armlifts today no longer always mean that it requires a scar to achieve it.

Dr. Barry Eppley

Indianapolis, Indiana

Smartlipo Arm Contouring

Tuesday, October 27th, 2009

The arms, like many other areas of the body, can suffer from lipodystrophy. On the back of the arms, unwanted skin and fat can hang down creating a larger and undesired appearance to them. Despite how well diet and exercise can help shape out other body areas, the arms are uniquely resistant to such efforts. If the amount of loose skin is large, like occurs after bariatric surgery and extreme weight loss, only an excisional arm lift (brachioplasty) can reduce the size of arms. While dramatically effective, this surgery leaves scars on the inside of the arms that are not insignificant.

Because the scars from brachioplasties are not a trivial consideration, this operation should be reserved for the most severe arm contour issues. For all other arm contouring concerns, liposuction is the only other treatment option.  Liposuction can not achieve the reduction or tightening effect of an arm lift, but moderate improvement can be obtained for many patients.  Liposuction of the arms is almost exclusively a procedure for women. Exercising and weight lifting typically does not reduce the volume of fat located on the arms, and most women do not want arms that appear muscular or masculine. A heavy, bulky arm gives the appearance of obesity, whereas a thinner arm helps to give the appearance of a thinner body.

Patients often misunderstand the goal of Smartlipo or laser-assisted liposuction of the arms. The objective when contouring the arms is to produce a more proportionate appearance (triceps:biceps ratio), rather than removal of fat circumferentially from the arms. Liposuction is directed to remove fat from the posterior or back part of the triceps muscles. The inner part of the arms does not have much fat and it contains important nerves and blood vessels, thus it is avoided when suctioning.

Smartlipo offers the advantages of removing arm fat using a very small probe and microcannulas. This avoids large entrance scars. Because the arm is very limited as to where these entrance incisions can be made (usually at the elbow) heating and melting fat is more likely to avoid irregularities than  the traditional use of multiple linear cannula tracks. Inadequately removing enough fat near its junction with the shoulder is usually what causes asymmetry or unevenness in the result.

There is no great risk to removing too much arm fat, short of causing unevenness. The opposite is more of a concern. Can enough fat be removed to make a substantial difference and the procedure worthwhile? Patients usually see results immediately after surgery when the wraps are removed after 48 hours.  But the final end result caused by fat removal and skin tightening will not fully be seen until about three months after surgery. For optimal reshaping and skin adaptation, I like to use compression with coban wraps in my Indianapolis plastic surgery practice for about seven to the days after surgery.

Barry L. Eppley, M.D., D.M.D.

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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