1. How do I know if an arm lift is right for me?
Deciding about an arm lift (also known as a brachioplasty) is a balance between how much does a scar bother you versus how much does the way your arm looks now bother you. In other words, would a scar running down the inside of your arm be better than the floppy saggy skin that is there now? It is about trading off one ‘problem’ for another. You just have to make sure the new problem (scar) is preferable to the way the arm looks now.
2. Would liposuction work as well as an arm lift?
In almost all cases, no. Liposuction only removes fat. And while some skin shrinkage (contraction) does occur with liposuction fat removal, that skin change is not nearly as much as the skin that is removed with an arm lift. When you look carefully at arms that are saggy, a lot of the problem for many patients is primarily loose skin which hangs down from the triceps area. While there certainly is some fat as well, the amount and stretched nature of the skin is usually the greater problem.
3. Will an arm lift get rid of loose skin in my armpit or on the side of my chest?
In many upper arm problems, particularly after large amounts of weight loss after bariatric surgery, the skin problem extends beyond the arm into the armpit (axilla) and even down onto the side of the chest or breast. When this occurs, one needs a modification or extension of the traditional arm lift procedure. The cut out pattern must extend beyond the arm (horizontal component)to include this vertical excess as well. This is known as an extended arm lift. The transition area in the axilla poses the biggest potential postoperative problem as any scar that crosses a joint area is prone to developing a tight scar band. When this occurs in the axillary region, the full upward motion of the arm may be restricted and painful. Secondary scar revision may be necessary.
4. Where and how long is the scar on the arm?
The scar will be as long as the distance between your elbow and the armpit. In an extended arm lift, the scar will be double that length as the vertical length of the scar extending down from the armpit may be just as long as the horizontal arm scar. In my opinion, I would be less concerned about the length of the scar and more focused on how the scar will look. Arm scars do tend to get wide and be red for sometime after surgery. And I have rarely seen what I consider a great armlift scar. Because of the location of the scar and that it is closed under considerable tension, they never turn out to be great-looking scars. That being said, most armlift patients do not undergo scar revision as they usually feel that however the scar looks is preferable to what they had before. This is also the reason why one should not undergo an armlift unless the arm problem is fairly severe. These type of scars are not a good trade-off for a minor arm sagging problem.
5. Is an arm lift painful?
Remarkably, no. The arm will feel tight and little sore, but there is no significant pain afterwards.
6. How soon after can I shower and use my arms?
I have my patients remove their arm wraps and shower after 48 hours. All sutures are under the skin and the incision is covered with tapes. There is no harm in getting the tapes wet. They will be removed in one week. In some cases, I do place a drain which is usually removed in two or three days after surgery.
7. Will insurance pay for my arm lift?
Unfortunately, no. While sagging arm skin is unsightly and does interfere with the wearing of certain clothes, its correction is not considered a medical necessity. The insurance companies do not see any medical benefit to be gained by its removal.
8. How can I improve the arm scar if it looks bad?
Arm lifts scars can be revised six months to a year after surgery if a patient desires. Seconday revision always produces a better looking scar as the skin is more relaxed, less tissue is being removed compared to the original arm lift, and the incision is closed under much less tension. One can use topical scar creams after the original arm lift surgery but they tend to have limited benefit in the arm lift scar.
Dr. Barry Eppley
Indianapolis, Indiana