An arm lift, also known as brachioplasty, removes excess, hanging skin from the underarm and allows reshaping of that area – from the armpit to the elbow. By addressing surplus skin, fat and the underlying tissues which have lost elasticity, an arm contour can be easily enhanced and more toned appearance achieved. Droopy, sagging upper arms soft tissues most commonly develop as a result of natural aging process, but can also be due to significant weight loss or rarely, as a hereditary feature.

As most patients experience, even regular exercise and strength training cannot get rid of excess sagging skin in this area; exercise can tone and tighten muscles underneath, but can not tighten skin, fat and subcutaneous tissue.

The following factors are associated with good outcome:

• Significant upper arm skin excess and laxity – only minor surplus of tissue usually does not justify postoperative scarring and risks of surgery
• Patients with relatively stable weight, but not overly overweight and/or obese
• Non-smokers
• Healthy persons who do not have medical conditions that can impair healing or increase risk of surgery
• Positive individuals with realistic expectations and committed to a healthy lifestyle and diet

It always helps to plan things in advance of surgery and adjust work and life activities accordingly. Therefore, please consider the following issues prior to your operation:

• Anticoagulation medication (Aspirin, Brufen, Warfarin, Clopidrogel) should ideally be stopped few days before the operation to reduce the risk of bleeding, but advise from the clinician who prescribed them is wise beforehand. I would strongly advise you to stop smoking prior to surgery as this can badly affect the outcome of surgery and increase complication rates.
• Please make sure that you arrange to be collected from the hospital as you will not be able to drive after the surgery.
• Plan your time off school / work / sports.
• Allow at least few weeks after surgery before considering a travel

Procedure is carried out on a day care basis and pending on amount of tissue that needs removing, can last between 1.5 – 2 hours. It can be done in conjunction with additional procedures such as liposuction or correction of other parts of the body in which case operation will last longer and will most likely, require at least one night stay in hospital. In most cases, general anaesthetic is used.

Cut (incision) is made on the inside of the arm. The length of incision and subsequent scar depends on the amount of excess skin that needs addressing, but in many cases cut can span from the underarm to just above the elbow. If there is a lot of fat excess, before the skin is opened, liposuction might be performed first. Excessive skin is then removed, tightened and sutured into place with deep (dissolving) sutures. Arm is bandaged from armpit to the elbow in order to control swelling and bruising. In case of extensive resections, wound drain (tiny silicone tube) might be inserted at the time of surgery to drain any excess blood or fluid that may collect. Drain is removed in the dressing clinic the following day.

In general, recovery is very straightforward and restrictions are minimal. Recovery may include mild discomfort right after the procedure, but patients very rarely report a need for pain killers. It is normal for some swelling and bruising to occur, 2-3 days after the surgery, but this settles within two weeks. By elevating your arm with pillows you can reduce swelling and increase comfort during recovery. Synopsis box indicates time intervals required for certain activities based on usual extent of tissue resected.

The results of arm lift surgery will be long-lasting, provided that you maintain a stable weight and general fitness. There will be some visible scars, but they improve with time and up to 18 months following surgery. Most patients are so delighted with contour improvement that they are happy to accept long scars. As the body ages, it is natural to lose some firmness in the arms, but most of your improvement from surgery should be relatively permanent.

Many patients who have an arm lift may also consider other body contouring procedures, such as liposuction, tummy tuck or thigh lift.

Complications are rare, but as with any surgical procedure, there are general and procedure (arm lift) specific risks which patients must be aware of:

General complications:

• Adverse reaction to general anaesthetic
• Clots in the legs/lungs
• Vein trombosis / inflammation (trombophlebitis)
• Bruising and swelling in the operated area
  (especially in patients on aspirin or anti-inflammatory drugs)
• Skin/wound infection
• Hypertrophic (lumpy and itchy) scars
• Delayed healing
• Numbness, alteration in sensation

Specific complications:

• Bleeding and haematoma collection (including the need to return to theatre)
• Seroma formation (fluid collection under the skin which might require repeated aspirations in the clinic)
• Asymmetry
• Fatty lumps and irregularities
• Surface irregularities (dimpling, rippling, loose skin)
• Prolonged numbness of the inner arm
• Swelling of the hands
• Long scars

This leaflet provides only basic and generic information, but full details and explanations are provided at the consultation as no two patients are the same and personal circumstances vary greatly between individuals.