Brachioplasty is a surgical procedure to rejuvenate the arms by removing excess fat and skin. It improves the appearance of the under portion of your upper arms.

As you get older, the skin on your upper arms changes often sagging and becoming loose. Individuals that have lost a significant amount of weight may have redundant skin on the upper arms. While exercise can strengthen and improve muscle tone in the upper arm, it can't address excess skin that has lost elasticity. Brachioplasty removes troublesome skin and fat to achieve a more desirable contour. It can be combined with liposuction to enhance the overall result.

An incision is made on the under the surface of the arm and extends into the armpit. The length and pattern of the incisions depends on how much skin will be removed. The incision can extend towards the elbow and can also extend down the side of the chest. Liposuction is often performed and then the excess fat and skin is removed. Internal stitches are used to tighten the internal part of the arm and the remaining skin is placed back over the newly repositioned contours to create a more toned look. I rarely use drains but you will have a compressive dressing.

Who Is a Good Candidate?

You should be in good physical shape and at your target weight that is stable before embarking on brachioplasty. Brachioplasty patients include men or ladies that have experienced weight loss and have been left with redundant skin on their arms. Other individuals request brachioplasty as they feel that their arms are out of proportion with the rest of their body and wish to remove excess skin and fat. Some candidates have experienced massive weight loss due to bariatric surgery and brachioplasty may be one of a number of procedures offered providing you are otherwise healthy.

Who Is Not a Good Candidate?

Those with significant medical problems and smokers are not suitable. If you have not yet achieved your target weight you should delay surgery to achieve the best long-term effects. Those with unrealistic expectations or those who have been encouraged by others to change their appearance are not good candidates.

What To Expect at Consultation

At your initial consultation, I spend a great deal of time getting to know you personally and taking a full medical history. The success of any cosmetic procedure relies on you being open with me at this stage. It is important for me to explore your reasons for seeking brachioplasty, what you dislike and your expectations of surgery. I also need to know about your general health, lifestyle and medications, prescribed or otherwise. I specifically need to know about previous operations.

I will examine your arms and your overall body shape to assess what components are problematic and what options are available. At the end of that consultation I will describe the surgical options to address your concerns and devise your personal surgical plan. I will also explain the risks and limitations of surgery to you at this stage. I always have a second consultation to answer any questions before we book surgery. 

As a female Plastic Surgeon I have an intimate understanding of how a ladies’ feelings about her body can affect self-image and femininity. I want to work with ladies to achieve the desired outcome whether that is being able to fit back into your clothes, to improve your self-confidence or to simply get rid of those bingo wings. For men I offer a woman’s perspective on your concerns and aim to help you re-create the physique you desire.

Preparing for Brachioplasty

You should be physically fit and at or close to your ideal weight which should be stable prior to embarking on brachioplasty. Your health will be assessed pre-operatively and you may need some tests that will be arranged if required. You should stop aspirin, anti-inflammatory medications and any non-prescribed medication at least a week before surgery. If there is any change in your health prior to your surgery date you should let me know. Your health and general well being are my primary concern when I am treating you therefore if you are unwell for any reason it may be necessary to postpone surgery.

What to Expect on the Day of Surgery

You will need to come to hospital starved and ready for a general anaesthetic. Surgery generally takes one and a half to two hours, and an overnight stay may be required. 

You will return to the ward around an hour after surgery and be encouraged to mobilise and eat and drink. You will feel swollen and bruised and you will be given appropriate painkillers. It is unusual to require drains but you will be given a compressive dressing. You should arrange for someone to pick you up following surgery and to offer you some support for a couple of days.

What to Expect After Surgery

Most patients go home later the same day but occasionally you may choose to stay overnight to recover from the effect of a general anaesthetic. You will be swollen and bruised. You will have some discomfort and will be prescribed some painkillers. You should keep the wounds clean and dry for the first week. You will be reviewed in the clinic at one week and the wounds checked.

You can return to light exercise at two weeks but should not do any heavy lifting for 6 weeks, including arm weights in the gym and picking up your children. You should arrange to take a couple of weeks off work.

Once the scar has healed you can start to massage with a simple moisturiser. Bruising and swelling will start to settle over the first few weeks and you may find that one side settles more quickly than the other leaving you asymmetric (lopsided) whilst the other side catches up. This is perfectly normal and we will not start to see the final results for at least six weeks. It can take several months for all surgical swelling to subside and for the very final results to be evident.

Risks And Complications Of Brachioplasty

When you are considering any type of surgery, you should be fully educated about potential risks and complications. Most patients are delighted with outcome of their procedure. Sensation usually changes following a brachioplasty. Although permanent numbness is uncommon, sensation can take a number of months to return. In addition to numbness, bruising and swelling are common. Uncommon complications include infection, haematoma, delayed healing, skin necrosis, skin loss, seroma (a collection of tissue fluid) and thickened scar. In the longer term asymmetry between the two sides or the scars can occur. The scars will be red or pink for a number of months and often turn purple before they fade to a pale white line. Some patients develop abnormally thickened scars that may require additional treatment in the clinic. It is very unusual to have scars that require additional surgery. Complications of any general anaesthetic include potential cardiac or respiratory problems and blood clots in the leg (DVT or in the lung (PE).

A brachioplasty can give your upper arms a more toned appearance and the results are typically long lasting. However, your skin will naturally lose some firmness as you age and some sagging might re-occur. Future fluctuations in weight can affect the results therefore maintaining a stable weight will preserve the results.

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