Introduction to Brachioplasty or Arm lift
Flabby arms, "Bingo wings", or "Bat wings" as they are sometimes called are a common complaint in women. The main reason some people develop this is usually due to hereditary factors, weight loss, and age. In fact there are 2 distinctly different type of patients who complain about their arms. The first type of patient is usually extremely lean with a low body mass index and is even fit but may have a history of chronic sun tanning. However due to age, or even long term smoking they may have developed some loose skin along the upper inner aspect of their arms which is more noticeable when the arm is hanging down and somewhat forwards. In this situation there is no problem with fitting of clothes or sleeves as the arm is quite lean, however the appearance of the skin on the upper inner aspect of the arm looks decidedly wrinkly and rippled.
The second type of patient usually has problems with bulkiness of the arm in addition to loosening of the skin. In these situations patients often have difficulty fitting into certain types of sleeves and in extreme situations have limitation of movements of the arm. Many times skin rashes and irritation develop and keeping hygienic can also be problematic. In both situations a Brachioplasty or arm lift can be very beneficial. Thankfully, a brachioplasty procedure or arm lift can help restore a person's ability and confidence to wear blouses and shirts comfortably, and therefore be able to show their arms without feeling self-conscious
An arm lift or brachioplasty is a plastic surgery procedure to reduce sagging, loose skin as well as any excess fatty tissue of the upper arm. It is performed to reduce the circumference of the upper arm and to remove lax skin thereby dramatically improving the contour and appearance of the arms.
This will be decided at your consultation. During your consultation Mr. Karidis will ask you about your general medical health and note any problems that could compromise the success of the operation
Men and women who are not good candidates for brachioplasty include those who predominantly have excess fat, which are better served by first losing weight. Also, people with Hidradenitis Suppurativa - a persistent ongoing infection of the sweat glands in their armpits, should not undergo Brachioplasty until treated appropriately. Finally, women who have had Radical Mastectomy or extensive breast cancer surgery are at risk of developing chronic arm swelling after undergoing brachioplasty.
If you are a smoker you will be asked to stop smoking well in advance of surgery. Smoking seriously constricts blood vessels and therefore decreases
blood flow to a given area resulting in poor healing. Aspirin and certain anti-inflammatory drugs and other medications (discussed in DO'&
DON'TS section) can cause increased bleeding, so you must avoid these.
A physical examination will determine if you are a candidate for an Arm lift procedure. The best candidates are men and women who are within several pounds (i.e. 10%) of their ideal weight. If you are significantly more than this then you will be asked to reduce some weight before going ahead with any surgery. Ideal candidates also possess loose enough skin and tissue laxity making the operation possible. This will be assessed at your consultation.
No. In situations when there is slight sagging of the skin, moderate fat excess and good, relatively taut skin tone then there are a couple of other options. Liposuction certainly is useful in these situations by removing the bulk of the excess fat in the region through tiny incisions. However if the skin is loose, then liposuction on its own will not tighten skin. In liposuction we rely on the patients good skin tone for the skin to snap back into position. With liposuction, in the presence of good skin tone, the skin usually knits back into a new slimmer contour with the arm.
Another option is a non surgical treatment using the Accent Radiofrequency device. This device is good at achieving skin tightening and "melting" small amounts of fat. It certainly has been proven to work. However at least six sessions are usually required and the degree of skin tightening is usually modest. Sometimes both Liposuction followed by the Accent device is utilized to achieve a slimmer tauter contour of the arms, whilst avoiding the long scars associated with the Arm lift. A consultation will determine your suitability for either.
The type of brachioplasty performed depends upon the amount and location of your excess skin. If excess hanging skin is located and limited to within a couple of inches from the armpit, then this excess skin can potentially be pulled up and tucked into the armpit with an axillary brachioplasty or mini arm tuck.
For those however whose excess skin extends like a "Bat Wing" from the armpit to the elbow, the only option is the complete removal of the excess arm fat and skin in a standard brachioplasty or standard arm lift.
The single most important consideration for any brachioplasty patients is the resulting scars. In fact scars are the greatest drawback in this operation. This is because in a standard brachioplasty the operation results in a permanent scar extending the length of the upper arm, from the armpit to the elbow which may be visible in short sleeve clothing. In fact this is the main reason why many patients decide against having this procedure. This operation basically exchanges one cosmetic problem (loose skin) for another (scars). In general, only those with very loose saggy skin are most likely to find this exchange worthwhile. Those with a small amount of looseness will probably not want the scars. Although initially all scars are somewhat red and lumpy, with time(12-18 months) the scars usually settle an improve. In most patients the scar heals well, but in a small number of people the scars can remain thick and heavy.
With a mini arm tuck of course, the scar is more limited to a semi-circular line hidden in the armpit. However it's important to understand that the vast majority of patients are probably more suitable candidates for a standard brachioplasty than a mini arm tuck . This scar is either placed on the inner side of the arm, which is hidden in a normal pose; or at the bottom of the arm just, like the seam of a shirt.
Before going down to theatre, Mr. Karidis uses a marking pen to draw on your arms in order to determine the exact amount of skin and fat he will be removing and to show you exactly where the incision will be. This is usually done with the patient standing. The incision length and pattern depend on the amount and location of excess skin to be removed. Generally however incisions are usually placed on the inside of the arm 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 accordingly.
During the operations, excess skin and fat is removed carefully whilst taking care to cauterize and stop any blood vessels bleeding. Some fat is left over the nerves and arteries for their protection. Following on, layers of sutures are used to stitch the wound closed.
Finally some tapes, and a light dressing are applied over the suture lines. A bandage is wrapped around the arms in order to apply some compression.
All sutures used are of the dissolving kind and will not need to be removed.
Mr. Karidis does not use drains routinely. He has deemed these not necessary and has stopped using them for a number of years, without any adverse effects. Patients appreciate the fact that they no longer require any drains to be pulled from under the wounds after the surgery.
This operation is usually performed under a general anesthetic, which means you are asleep. The operation usually takes about 90 minutes to perform
If the operation is performed in the morning then most patients are able to go home later in the afternoon and therefore have this done as a day procedure. Alternatively if you prefer you could stay in overnight at the Hospital.
The following day after surgery, you will be instructed to remove your bandages and slip into your surgical support garment which will be both more comfort and aid in the proper healing. This should be worn for the first 3-4 weeks following surgery.
It is advisable to take at least a week off from work and you can return to exercise in about 2 -3 weeks.
No it is not advisable. After any surgery you will be under the influence of medications and so it is dangerous to drive home. If you do not have anyone to drive you home we would be happy to call a taxi.
Whilst it is true that when a Brachioplasty is performed by a qualified plastic surgeon the risks are small, nonetheless, specific complications with this procedure can and do occur.
As in any procedure the risk of significant infection is always possible. This is minimised by careful surgical technique and the preventative administration of antibiotics both at the time of surgery and after. However despite these measures mild infection is relatively common and can occur around the incision site, but usually subsides over a period of about 2 weeks.
Excess bleeding may also occur, which in rare circumstances may require readmission to remove any excess blood accumulation.
During the first 2 -3 weeks after surgery, some patients may experience a minor loss of wound adhesion at any point of the wound site. This is a temporary complication, which will require regular dressing changes initially. Eventually a scab develops over this, which subsequently separates after 3-4 weeks. However some distortion of the skin around the scar may ensue particularly if this has occurred over the hip region. Further revision surgery may be required if necessary.
After all operations there is usually some bruising and swelling. This lasts about two weeks but can continue for a month or more. Remember that the human body is asymmetrical and that even after surgery both sides of the body will look different. All surgery requires an incision and therefore will leave a scar. At the time of surgery the small nerves that supply feeling to the skin are damaged. This may cause changes in sensation including numbness. Although uncommon, bleeding and infection are risks and can be serious.
You will have some pain and discomfort after this surgery. However it is not considered a particularly painful procedure. The pain usually only lasts for a few days and of course you will be given appropriate pain killers to control this.
One per cent of all operations lead to major complications. Weigh up the pros and cons, it is for you to decide. This is a surgical procedure and as such potentially serious complications such as a blood clot or embolus or an unexpected response to drugs or anesthetics can occur. Beside the complications that can develop after any surgery, there are problems that are special for your surgery. These include: the scar is long and may be slow to heal, it is not unusual to have scabbing along the scar for several weeks, and fluid(either blood or serum) can collect under the skin flap.