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Background: Loose skin develops over time around joints due to their repetitive motion. The skin around knees and elbows must be flexible to allow the range of motion needed for all forms of physical activity. But this tissue flexibility and repetitive motion adds up over time to create rolls of skin above the joints.

Removal of this excess skin (knee and elbow lifts) involve the excision of skin rolls above the joint. While that can be effectively done, the tradeoff of the scar must be very carefully considered. A wide scar or a postoperative wound dehiscence would likely create an aesthetic result that would not be viewed as better than the original skin rolls.

The key to a successful lift around a joint is the preoperative markings. They must be done with the motion of the joint considered into the amount of the skin excision pattern. Without this consideration it is easy to remove too much skin and create adverse healing and scarring.

Case Study: This middle-aged male was bothered by skin rolls that had developed above the elbows on the back of his arm. He had a lean body frame and the skin rolls could be pinched up to two inches of excess skin.

Preoperative markings were done both in a conservative excision (solid upper line) and maximally with the pinch test. (dotted upper line)

Under general anesthesia (he was having many other procedures as well) the elbow skin excisions were done slightly inside that of the original conservative markings. This was done as the elbow was bent at 120 degrees, accounting for any range of motion after surgery in the healing process.

Elbow lifts do create scars. But as long as they stay very narrow and do not extend any further than the medial and lateral epicondyles of the elbow, they will create minimal scarring.


1) Excess skin can occur around the elbow in both women and men.

2) Preoperative elbow markings must be done with the arm both fully extended and flexed.

3) The skin removed should be conservative and within the skin makings to prevent adverse scar widening or even wound dehiscence.

Dr. Barry Eppley

Indianapolis, Indiana

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