Arm Lift after Massive Weight Loss

Being left with loose, sagging skin in your upper arms after weight loss can be discouraging and embarrassing.

At San Antonio Plastic Surgery Center, Dr. Peter Fisher can perform an arm lift to help you look fit and enjoy the results of losing weight.

So why should you consider an arm lift after massive weight loss?

Woman pinching skin on upper arm

Achieve the Results You Deserve after Weight Loss

Refine Your Upper Arms

During an arm lift procedure, Dr. Fisher can remove excess skin and fat before tightening remaining tissue. This treatment can result in a slimmer, more defined upper arm and an overall fitter appearance.

Raise Your Confidence

Excess skin and stubborn fat can prevent you from feeling fully comfortable with the results of weight loss. An arm lift can help you feel more confident about your appearance and open up a broader range of clothing options.

Celebrate Your Hard Work

Stretched skin in your upper arms can hide the results of dieting and exercise and prevent you from enjoying the results of your hard work. Dr. Fisher can address your concerns for improved mobility and attractive results.

Let's take a look at how arm lift surgery works...

Do many people undergo arm lifts?

Thousands Turn to Surgery To Enhance Their Upper Arms

So what does arm lift surgery treat?

Wondering whether you qualify for treatment?

We Recommend Arm Lifts for Patients Who Want to Address Substantial Concerns

Significant Loose Skin

Dr. Fisher will typically recommend an arm lift only for patients who want to address significant stretched skin and stubborn fat.

Stable Weight

It is important to wait until you have reached your weight loss goal before pursuing surgery because weight fluctuations can affect your results.

Overall Good Health

Certain medical concerns, such as autoimmune disorders, can prevent you from healing properly and increase the risks of surgery.

Tobacco Use

Smoking can also affect your ability to heal safely and raise the risk of complications.

Realistic Expectations

There is a limit to what an arm lift can provide, so be sure to thoroughly explain your goals with Dr. Fisher during your consultation.

Arm Lift Techniques

Brachioplasty over the past six years has increased ten -fold. The major reason for this is the increased number of patients undergoing bariatric procedures. Commonly performed with Mastopexy (breast lift), an arm lift surgery is done as an outpatient procedure. It involves the removal of skin and fat essentially using two techniques:

Under the Arm, or Posterior Incision

This runs along the underside of the arm, from anywhere near the lateral aspect of the breast to the elbow and extremely rarely to the wrist. This procedure is performed for the considerably better scar it leaves as compared to other types of arm lifts.
Pros:

  1. The dissection is posterior to the antibrachial cutaneous nerve, thus virtually no chance for injury to it and the very unwanted side effects of numbness and burning that go with it,
  2. An incision that generally heals better, thus leaving a better scar than the anterior technique.
  3. Because the skin and fat is removed from the front and back of the arm, there is no added weight for gravity to pull on and therefore less recurrence of the problem. The skin that is being stitched together is of similar consistency leading to the better scar.

Cons:

  1. The scar can be seen from behind when the patients arms are by their side.

Inside the Arm, or Anterior Incision

This incision leaves a scar in the hair bearing portion of the arm and side of the chest. It can only be used in minor cases when the excess skin is confined to the medial third of the arm.
Pros:

  1. When the arm is by the patient’s side, the scar cannot be seen.

Cons:

  1. When the patient’s arms are up for any reason, the scar is visible
  2. The scar in this position frequently widens and can stay red and angry looking for years.
  3. It is harder to maintain the result long term because a flap of skin and subcutaneous fat is rotated from under the arm around to the front, allowing gravity to pull down on it.

*Note from Dr. Fisher: These pros and cons are my own findings from 24 years in practice and from evaluating multiple journal articles and photos from them. My obvious bias is toward the posterior incision.

An arm lift, or brachioplasty, trims excess skin from the arms, typically after massive weight loss due to bariatric surgery. Dr. Peter Fisher typically performs what is known as an extended arm lift, which plans treatment all the way down to the forearms and wrists.

Extended Brachioplasty

Techniques have changed somewhat to deal with the differing presentations of skin laxity and their extremes. This has become a much more extensive procedure with these deformities sometimes extending to the wrist on one side and onto the lateral chest and back areas on the other side in some patients.

Extension can be in one of two directions. Either toward the side of the chest (most commonly), or towards and all the way down to the wrist (5% of my practice).

As mentioned earlier, there are two reasons to extend the incision towards the side of the breast. One is because of continued excess skin from the arm along the side of the breast and the other is for loose excess skin of the upper outer back. Both will result in a J shaped incision which runs from the armpit along the outer aspect of the breast to the inframammary (crease at the bottom of the breast) crease. This incision will join an incision that is usually made when and if a breast lift has or will be performed. If the upper outside loose skin of the back is extensive then a T incision in the middle of the J portion will need to be made that runs towards the middle of the back in the bra line.

In approximately 5% of my patients an extended incision is continued down to the wrist along the inside (ulnar) aspect of the forearm. This is usually done at the patients request and if I agree that an acceptable result can be obtained.

Pre-operative instructions.

It is essential to stop all kinds of female hormones at least two weeks prior to any surgery. These include BCP’s and any other estrogen and progesterone combination pre and post-menopausal.

Other medications to stop include all non-steroidal anti-inflammatory meds and vitamin E.

Patient is seen pre-operatively in the office for photos, prescriptions, markings and to answer any final questions.

Procedure.

A brachioplasty is performed last if other procedures are being done at the same time. Under general anesthesia the markings are reinforced and infiltrated with marcaine and epinephrine. If performed with liposuction, a wetting solution is infiltrated into the areas that will be suctioned.

The area of fat under the area to be excised and any adjacent areas of excess fat are then suctioned. Then, the anterior incision is performed along its entire length. The skin and any remaining underlying fat is dissected backwards close to the underlying muscle. The posterior incision is then made and all the excess skin and fat removed.

Incisions are closed with one layer first and the two arms are then checked for symmetry, shape as well as making sure the correct amount of tissue has been removed. Drains are rarely used. A final layer of buried skin suture is run. Antibiotic ointment, non-stick gauze and kerlix wrap are then placed.

Post-operative instructions.

Two layers of suture are placed, all dissolving and buried. No drains are used. If done by itself or with a breast procedure then the patient is discharged home after an appropriate time in the recovery and post-recovery rooms. If performed with a more extensive procedure then the patient is kept in the hospital. Drains are almost always not used.

The patient may shower two days after surgery. Antibiotic ointment and non-stick gauze applied daily for about a week. There are no restrictions to lifting and or using your arms to lift yourself. A post-operative return appointment is usually made for five to seven days after your surgery.

View Gallery for Before and Afters

Exceptional Cosmetic Care by  a Board-Certified Plastic Surgeon

Peter Fisher, MD

You can achieve superior results with Dr. Peter Fisher, who is:

  • Board-certified 
  • Trained in advanced techniques
  • Dedicated to providing superior results
  • An expert with nearly 30 years of experience 
  • An authority in the field 
  • Passionate about personalized care

To schedule your consultation, contact our practice online or call us at (210) 616-0798.

Contact Our Practice

Dr. Fisher has been available to answer all of my questions and provide me with not only professional medical expertise, but also a much appreciated level of personal empathy. I would 100% recommend Dr. Fisher to anyone who is considering plastic surgery.

Brandi

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San Antonio Office

7950 Floyd Curl Dr
Ste 1009
San Antonio, TX 78229

Open Today 8:30am - 2:00pm

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