A number of factors, including weight fluctuation, age and genetics can cause your upper arms to droop or sag. You may have improved the underlying muscle tone of your upper arm, but exercise will not help the extra skin that has lost its elasticity, underlying weakened tissues or localized fat deposits. An arm lift can:
- Reduce excess skin and fat between the underarm and the elbow
- Reshape your arm to result in smoother skin and contours
- Result in a more toned and proportionate appearance
About the ProcedureAn arm lift, or brachioplasty, is a surgical procedure that reshapes the under portion of the upper arm, from the underarm region to the elbow. The procedure is performed to:
- Reduce excess sagging skin that droops downward
- Tighten and smooth the underlying supportive tissue that defines the shape of the upper arm
- Reduce localized pockets of fat in the upper arm region
- Adults with significant upper arm skin laxity
- Adults of any age whose weight is relatively stable and who are not significantly overweight
- Healthy individuals who do not have medical conditions that can impair healing or increase risk of surgery
- Individuals with a positive outlook and realistic expectations
ConsultationYour consultation is your time to ask the doctor about the procedure you’re considering, how he thinks it will work for you and any concerns you may have. We suggest you come prepared with your questions on paper so you’re sure to ask the questions important to you. Questions to consider: What is the simplest and safest surgery to help me achieve my goals? How is the surgery performed? What is the expected length of operation? Are other options available? What results can I expect, and how long do the typical results last? Where will scars be located, and how noticeable will they be? Will scars fade over time, and how long will this take? When you arrive at the office, you will be asked to fill out a few pieces of paperwork. It is very important when asked about medications to put down all medications you take, including any supplements or aspirin-type regimens, since these items can impact your blood clotting and pressure. In addition, you need to be truthful about your use of tobacco and alcohol since this will affect your recovery and incision healing. Before you see the doctor, a nurse or nurse practitioner will do an initial exam. You may be able to get a number of your questions answered while with the nurse. Your surgeon will discuss several factors regarding surgery during your initial consultation, including your procedure, location, anesthesia and recovery. In addition, the surgeon will inquire about your concerns, priorities and motivations for pursuing surgery, as well as your fears. The doctors are sure to address reasonable expectations for the outcome of your desired procedure, and they should explain what is possible and what is not possible. After your consultation with the physician, you will meet with the practice manager to discuss procedure costs.
Pre-ProcedureThere are a number of things to do prior to your procedure that will make your recovery as smooth as possible and ease your pre-procedure anxiety. Your surgeon will give you instructions on what medications to stop taking prior to your surgery to prevent any unwanted side effects. Medications you shouldn’t take up to two weeks prior to your surgery include, but are not limited to, aspirin and products containing aspirin, alcohol and herbal supplements. Your surgeon may advise you to take Arnica Montana, Bromelain or vitamins A or K for swelling, bruising and to promote general healing. It is important to remember to only take a supplement or herbal remedy if your surgeon advises it. Your Pre-Op Checklist
- Take pictures and make notes to discuss with your doctor. You know what you want, and he knows how to make it possible.
- Make a list of post-op projects and gather what you need. Stop taking blood-thinning medications and supplements two weeks prior to surgery (aspirin, Motrin, fish oils, vitamin E) and don’t take them two weeks after surgery.
- Start using anti-bacterial soap in the shower a few days before surgery and following surgery.
- Remove all fingernail and toenail polish.
- Fill prescriptions you’ll need, including antibiotics and pain medications.
- Purchase over-the-counter eye drops and eye gel for overnight (GenTeal seems best and it is found at major drug stores like Walgreens)
- Pick up Bacitracin for incision areas and Colace to keep your bowels moving during recovery.
- Clear your calendar for a month post-op.
- Arrange for caretakers: you, kids, plants and pets need to be taken care of during your recovery. You will not be able to lift, reach, bend over or be too active for some time.
- Prepare your recovery area so your head is elevated. A recliner works wonders for this. Also stock your recovery area with blankets, water, phone, lotion, tissues, remote control, reading material, laptop, etc.
- Make a to-do list of things you want to get done prior to surgery and start! You won’t be able to accomplish as much post-surgery. Some items you may want to get done include:
- Stock up on groceries and easy to prepare meals
- Clean the house
- Catch up on gardening
- Give the dog a bath
- Clean the litter box
- Wash your car
- Stock up on ice packs, frozen peas and frozen gel packs. You’ll want to use them early and often on your face, neck and ears. It will definitely feel good and keep the swelling down.
- Pack a receptacle with a lid and towel in your car for the ride home from the hospital just in case you feel nauseous. You may want to add a pillow and blanket, but be sure to set up on the ride home to help with the nausea and swelling.
- Get your hair and nails done since it will be a while before you can do either.
- Prepare Power of Attorney for Medical Care and Advance Directives, just in case. Give copies to your doctor and/or surgical center.
- Breathe and relax! Stress can adversely affect your recovery. Try to remember that you will heal, the soreness will subside and you will look great.
During Your ProcedureAnesthesia: Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you. The incision: Incision length and pattern depend on the amount and location of excess skin to be removed, as well as the best judgment of your plastic surgeon. Incisions are generally placed on the inside of the arm or on the back of the arm, depending on the surgeon’s preference, and may extend from the underarm (axilla) to just above the elbow. If fat is to be reduced during your arm lift, it will be excised or treated with liposuction. Inner Arm Incision Back of Arm Incision Minimal Incision Closing the incisions: Your incisions will be closed with absorbable sutures, or stitches that will be removed within 1-2 weeks following your arm lift. Results: The smoother, tighter contours that result from brachioplasty are apparent almost immediately following your procedure, although initial results will be somewhat obscured by swelling and bruising. Your new, shapely and toned upper arm is dramatically improved both in appearance and feel.
RecoveryFollowing your surgery, dressings or bandages may be applied to your incisions, and your arms may be wrapped in an elastic bandage or a compression garment to minimize swelling. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. Recovery is an important part of any surgery, and you must take the doctor’s orders to heart if you want to heal as quickly as possible. You will be given specific instructions that may include: how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up with your plastic surgeon. Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period. Where will I be taken after my surgery is complete? What medication will I be given or prescribed after surgery? Will I have dressings/bandages after surgery? When will they be removed? Are stitches removed? When? When can I resume normal activity and exercise? When do I return for follow-up care?
RisksAs with any surgery there are risks. Discuss these risks with your surgeon freely.
- Unfavorable scarring
- Bleeding (hematoma)
- Fluid accumulation
- Anesthesia risks
- Poor wound healing
- Skin loss
- Blood clots
- Numbness or other changes in skin sensation
- Skin discoloration and/or prolonged swelling
- Major wound separation
- Fatty tissue found deep in the skin might die (fat necrosis)
- Damage to deeper structures such as nerves, blood vessels, muscles, and lungs
- Pain, which may persist
- Deep vein thrombosis, cardiac and pulmonary complications
- Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
- Possibility of revisional surgery