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Brachioplasty is a technique used to reduce the excess sagging skin that droops downward when the arm is extended away from the body. It tightens the underlying supportive tissue that defines the shape of the upper arm and occasionally the underarm and upper chest. The skin of the upper arms is thin and has poor elasticity. There is a broad spectrum of change in arm contour after dramatic weight loss. Many patients who have undergone dramatic weight loss have upper arms with excess hanging skin, which appear deflated, while others continue to have excess fat. These changes can extend from the side of the chest into the underarm, and below the elbow. For this reason, the arms are a common area for weight loss patients to request correction and require specialized techniques.
Ideal candidates for brachioplasty with skin removal alone have minimal to moderate fat and mostly excess hanging skin. If the upper arms still have a significant amount of excess fat, they may require liposuction in combination with skin removal to obtain a desirable result.
The brachioplasty procedure typically takes two to three hours to perform. It can either be performed as an outpatient or an inpatient procedure depending on the patient’s desires and if it is combined with another procedure. It is typically performed with a general anesthetic, but in certain cases a “twilight” anesthetic may be appropriate. Dissolvable sutures are used for skin closure and a drain tube is usually placed under the skin of each arm and is removed after several days. In order to reduce swelling, the arms are elevated and specialized compression dressings are placed on the arms for approximately two weeks. The discomfort from this procedure is relatively mild compared with other body contouring procedures after weight loss.
The main issue to consider when deciding to have a brachioplasty is the scar. Unlike the scar from the abdominal contouring procedures, which can be hidden in undergarments and swimwear, the scars from a brachioplasty may be visible when short-sleeve shirts are worn. However, most patients that have significant excess skin have indicated that they prefer the scar (which fades with time) over the excess hanging skin. Rather than see the scar as an impediment to wearing a short-sleeve shirt or tank top, the brachioplasty makes wearing these clothes a possibility never before imagined!