An arm lift procedure, or brachioplasty, is a common surgery performed on massive weight loss (MWL) patients who develop a large amount of redundant skin in their upper arms.
However, a small percentage of arm lift patients ask for the procedure to correct the appearance of their aging upper arms that typically comprise of excess sagging skin, loose supportive tissue, and/or fat atrophy (shrinkage or disappearance).
Unlike MWL patients who require longer incisions (from elbow to the underarm) and more extensive approach, older patients who have maintained a healthy weight throughout their lives will require just a short incision hidden inside their armpit. This will allow them to wear sleeveless tops without having to worry about visible scars.
Nevertheless, the amount and location of the excess skin will dictate the incision pattern and length. Fortunately, the scars are generally positioned on the inside of the upper arm or within the natural skin creases of the armpit to hide them.
With the use of short incisions, doctors are able to remove a small amount of excess skin and tighten the underlying supportive tissue; the latter technique is important to eliminate the tension on the skin, allowing the wound to heal without spreading or becoming uneven.
Some older patients have significant fat atrophy, which also contributes to the saggy appearance. This problem is corrected by fat replacement or fat grafting in which their own fat—typically derived from their tummy and hips through liposuction—is used to reshape the upper arms.
Meanwhile, others have excess or localized fat deposit, which is best treated by minimal liposuction. To achieve smooth results, the entire circumference of the upper arm or at least 75 percent of it must be treated, and some fat layer must be preserved as well to prevent gaunt or overly muscular appearance.
Aside from the shorter arm lift scars, another advantage of performing it on older patients is their reduced susceptibility to aggressive scars—e.g., keloids and hypertrophic scars. However, it remains imperative to avoid sun exposure six months to a year after surgery to prevent hyperpigmentation in which the scars turn darker and more visible.
While sunscreen is helpful in preventing hyperpigmentation, experts from the California Surgical Institute recommend long sleeves or any protective clothing when going outdoors.
To further improve the postop results (i.e., to promote skin adhesions), most surgeons recommend the use of compression garments continuously for at least four weeks.