With advancing age, and sometimes following major weight loss, the upper arms can become 'flabby', with excess skin that sags when the arm is held upright. Many patients I see with this problem will wear only long-sleeved shirts and dresses. In some patients the problem is primarily excess skin, in others it is mainly excess fat, and many it is a combination of both.
Brachioplasty is designed to remove excess upper arm skin (and some cases, fat as well) and requires an incision that runs from the underarm area to the elbow. The scar is placed in the inner aspect of the upper arm, facing the side of the chest, to help conceal its presence. This is a great operation for fair-skinned patients who are generally in their fifties or older, as the skin is often fairly thin, and results in a scar which is faint and minimally visible. In younger patients, this fairly long scar tends to widen, become pigmented, and even thicken - which means that younger patients must seriously consider if the scar is an acceptable trade-off for the improvement in upper arm contour.
In some cases, when the skin excess exists primarily in the upper half of the upper arm, the skin excision can be performed in the underarm area only, avoiding the scar along the inner aspect of the upper arm. Underarm incision brachioplasty can often be combined with liposuction to produce a very favorable upper arm contour. This can be a good option for some younger patients and for those with more deeply pigmented skin. In some patients with an 'in between' amount of skin laxity, the underarm incision may be combined with an incision that extends only halfway down the arm, thereby avoiding the 'armpit to elbow' scar
Upper arm recontouring with liposuction only
In some patients, a nice improvement in upper arm contour can be accomplished with liposuction alone. Individuals that have a minimal excess of skin, in whom the 'sagging' appearance of the upper arms is mainly due to excess fat, are good candidates for liposuction of the upper arms. The better the upper arm skin tone, the better the liposuction result will be. If the skin tone is somewhat lax, the improvement may not be as dramatic as with a formal brachioplasty, but the long upper arm scar is avoided.
As with all plastic surgery procedures, the approach to surgical rejuvenation of the upper arms must be carefully individualized to meet each patient's specific circumstances and personal goals.