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Arm lifts have a surprisingly long history dating back well over fifty years ago when it was initially described. While once only done as an occasional procedure for the diet-induced weight loss patient, the number of armlifts now done has virtually exploded since the increase in bariatric surgery procedures. While once done as an isolated procedure, armlifts are now more commonly done in conjunction with other body contouring procedures as part of a multiple-operation body contouring procedure.

While arm lifts are very effective at reducing the circumferential size of the upper arm, they do place a scar in a disadvantageous location that is prone to wound breakdown, scar hypertrophy and prominent scar visibility. As a result, the desire for a revision of an arm lift is not rare to improve the appearance of the scar or remove more arm tissue.

In addition, another change in arm lift surgery has been the concomitant use of liposuction to get a better result. Removing fat from parts of the upper arm that are not affected by the tissue excision, as well as around the shoulder, helps produce a better upper arm contour. Whether concomitant liposuction increases the risk of arm lift healing problems has not been well studied.

Since many arm lifts today are done in conjunction with other body procedures, it would be relevant to know if this impacts their results, incidence of complications and need for revision. In the April 2013 issue of the journal of Plastic and Reconstructive Surgery, a review of armlift (brachioplasty) outcomes was reported. From a multipractice pool of 69 patients, half had an armlift done as part of a collection of body contouring procedures and half had arm liposuction done as part of their armlift. Major complications occurred in 18% of the patients and included hypertropic scarring and infection. Revisions of the armlifts were done in over 20% of the patients.

This study found that combining arm lifts with other body contouring procedures did not increase the risk of complications. In addition, the use of liposuction in armlifts did not increase the risk of complications either. Higher complications rates were found, however, in patients who previously had bariatric surgery.

The revelance of this study supports what I counsel my Indianapolis arm lifts patients in regards to what they can expect after surgery. Arm lifts are easy to go through and are extremely effective…but at the price of a scar that can be problematic and may require a scar revision later if one is seeking the best apppearance of it as possible. The incisional closure is also prone to minor wound healing problems most commonly seen up near the armpit area. The change that I have done in my arm lift surgery technique was to place the excision and scar on the back of the arm rather than on the inside of the arm where the skin is thinner.

Dr. Barry Eppley

Indianapolis, Indiana

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