What is it?
In our warm Texas climate, patients often wish to feel comfortable in sleeveless tops and dresses and the complaint of flabby arms can often detract from this desire. Having toned and sculpted arms is hugely important to most patients, and a brachioplasty can help make the changes you need to love your arms! There are several different ways of performing a brachioplasty. If you have good skin tone with some extra fat that you would like to remove to make your arms more sculpted, liposuction alone may be all that you need. If you have extra fat and a small amount of loose skin, you may be a candidate for liposuction with a limited brachioplasty. A small ellipse of tissue is removed in the armpit which leaves a fairly inconspicuous scar. If you have a lot of extra tissue/skin a full brachioplasty with liposuction is most appropriate. Often this is the procedure necessary for patients after massive weight loss. A full brachioplasty involves making a long linear scar between the elbow and the armpit, often extending onto the chest wall. Usually the scar is hidden on the inside of the arm so that it can only be seen when you raise your arms. It is sometimes possible to place on the back of the arm as well, if that is what you prefer. Because we use our arms in everything we do every day, there is more pulling and tension on the incision as it is heals in comparison to most of the other areas of the body we operate on. Because of this, the postoperative scar tends to become somewhat thick and wide. This can generally be revised in a second smaller surgery with some improvement. Most patients are so satisfied with the improved contour of their arms, however, that they are willing to accept this scar, especially because it can be hidden in most situations. Once you have healed from surgery we will also discuss other scar management tips with you. Prior to surgery we will also ask you to purchase compression garments. If you want an arm lift in Houston, visit us at Lift Plastic Surgery.
What happens during surgery?
On the day of surgery, the proposed incisions and areas of fat removal will be marked in the pre-operative area. During surgery, we begin by performing liposuction of the designated areas. For a limited incision lift, an ellipse of skin and fat is removed from the armpit so that the incision is hidden in a natural crease and the wound is closed with absorbable sutures. In a full brachioplasty a long incision is made, usually on the inner arm, from the elbow to the armpit, and sometimes extending down onto the chest. The skin and fat is lifted off of the deeper tissues, taking care not to injure nerves. We check to see how much tissue can be removed safely while still being able to close the incision. This is marked, the tissue is removed, and the incision is closed with absorbable sutures, and then covered with tapes and skin glue. A drain is usually placed in each arm which is removed after several days in the office. You will then be placed into a compression garment. You are able to go home the same day as surgery, and you will be able to start showering the next day.
What will my recovery be like?
Postoperatively, you will have some discomfort, bruising and swelling, but it is usually not significantly painful. You must wear a compression garment at all times other than showering for the first 6 weeks to limit swelling and improve your results. No vigorous exercise or activity is allowed for the first 6 weeks after surgery. You should limit use of your arms and lifting above your head as much as possible to improve the end result of your scar. Expect that it will take several months for the swelling to subside before you will see your final results. One perk of the operation that many patients mention is the fact that a portion, if not all, of the hair bearing skin of the armpit is removed. This will decrease, if not eliminate sweating, as well as the need to shave or wear deodorant.
What are the risks?
With a full brachioplasty, it is not uncommon to have some small areas of the incision that open up. These wounds are usually easily managed with dressing changes and generally heal on their own without requiring further surgery. However, this may also increase the thickness or width of your scar. There are some sensory nerves in the area of the surgery that can potentially be injured. We take every precaution to avoid this. However, if it were to happen, you may experience some numbness of the inner arm and armpit that could be permanent.
What is involved in staging the procedure?
In instances where there is a significant amount of tissue and fat that needs to be removed, sometimes the best results come from staging the procedure. This involves first performing an aggressive liposuction to debulk the tissue, allowing the tissues to heal and the swelling to subside over several months, then coming back in a second operation to remove the tissue. By staging the procedures, more tissue is usually able to be removed overall.