INTRODUCTION

Arm lift (medical term is brachioplasty) is usually performed to remove excess skin hanging from the underarm and reshape the underarm portion of the upper arm. It can help to enhance the contour of the arm offering a more tone appearance.  The smoother and tighter contour that results from an arm lift is visible almost immediately. Patients who asked for brachioplasty surgery are usually in their forties and older. Younger patients who have sagging upper arms due to hereditary or as a result of weight loss are also good candidates for this procedure.

Depending on the amount and location of excess skin and fat to be removed, different types of procedure can be considered. An invisible arm lift is a procedure to remove excess skin and fat from the arm pit resulting in a short scar within the arm pit crease. The surgical steps of an extended arm lift or chest lift are similar to the traditional arm lift with a few technical differences. Brachioplasty can also be done in conjunction with liposuction of the arms and chest to give a better result.

During the initial consultation, patients will have the opportunity to discuss their goals and desirable results with the plastic surgeon. Every patient is different, therefore a specific treatment regimen is planned to suit an individual’s need.

PROCEDURE

The procedure is usually performed under general anaesthesia. The surgery takes about 2 hours and can be done as a day case for certain patients. Incisions are made on the inside and the back of the arm. The incisions may extend from the underarm to just above the elbow. Working through these incisions, the surgeon separates the skin and fatty tissues from the underlying muscle and removes excess fat and skin. The incisions are then closed with very fine sutures. Usually a single drain is left inside each arm to drain excess fluid and blood. These will usually be removed after 24 hours.

Once the procedure is completed, a compression dressing will be applied on each arm. You are advised not to drive yourself back as the swelling from the surgery might affect you. The surgeon will advise you on how to take care of the wounds at home and you will be given a follow-up appointment.

CANDIDATES
  • Generally healthy individuals or those with well-controlled medical conditions such as hypertension or diabetes
  • Individuals with clear and realistic expectations of their desired result
  • Individuals with stable weight
RISKS

Although serious complications from brachioplasty are uncommon, potential candidates should understand that every procedure comes with it a certain risk for possible complications and has a recovery period (down time). Preoperative preparation and postoperative preparation will minimize their incidence.

The more common complications from brachioplasty are:
  • Bleeding (primary or secondary)
  • Swelling
  • Bruising
  • Infection
  • Poor wound healing
  • Numbness
  • Scarring
  • Skin discoloration
  • Asymmetry
  • Possibility of revision surgery
  • Anaesthesia risks
  • Fluid accumulation

The risks mentioned above can be minimized if proper preoperative and postoperative instructions are adhered to.

PRE-OPERATIVE PREPARATION
  • Stop all non-medical supplements for at least one week before surgery.
  • Stop taking any anti-inflammatory pain medications , blood thinning medications (anti-platelets, anti-coagulant), and aspirin one week before the procedure.
  • All medical conditions (hypertension, diabetes, etc) need to be optimized prior to surgery.
  • Smokers need to stop smoking well in advance.
  • Some individuals might require prior blood investigation or further medical assessment.
POST-OPERATIVE EXPECTATIONS

After the surgery, there will be some swelling, bruising, discomfort, numbness and discoloration that can be controlled with oral medications, cold compression and ointments. The swelling and bruising usually last between 2-4 weeks but in some patients, this can last longer.

Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain respectively. Stitches will be removed about 7 days after the surgery. The final result of surgery will appear within several weeks, but it may take up to a year for the scar to fully mature.

POST-OPERATIVE CARE
  • Cold compression with an ice pack the first day and night after surgery
  • Bed rest with your arms elevated to reduce swelling
  • Wear compression garment for 4-6 weeks after surgery
  • Avoid excessive arm movement for the at least 4 weeks after the surgery
  • Avoid strenuous activities and swimming for 2 weeks
  • Regular antibiotic ointment on the surgical wounds
– COPYRIGHT OF DR LEOW AIK MING