Arm Lift

Are you thinking about Armlift?

If you are considering surgery, we want you to be thoroughly informed about this procedure. Reading this information is the first step. However, a personal consultation with your surgeon is the best way to obtain any additional information you need. Brachioplasty

Batwings, arm flaps or just loose arms skin…. Call them what you will, there is no doubt that loose skin in the upper arm is considered unattractive. No age group is immune to this problem and even if the skin is firm, some people simply have too much tissue in the upper arm. The thickness or circumference of the upper arm can be well out of proportion to the rest of the body.

It makes fitting clothes difficult and wearing short sleeved shirts, shirts or singlets becomes ver y awkward f not impossible. You become selfconscious and it can affect your self-confidence.

There are several different problems that I see. The f ir st is the young woman who has the out -of - proportion arms that won’t fit into the short-sleeved shirts. They have good, firm skin and no looseness in the skin. All they want is to bring the arms into natural proportions so they are not restricted in what they can wear. This problem is relatively easy to deal with as it can be corrected well with simple liposuction. The tiny 5mm incisions a re placed discretely in the armpit crease and will become virtually invisible in a short period. This procedure can be performed in day surgery with usually no more than a day’s worth of downtime.

The second is the middle aged person, both male and female, who are starting to show signs of advancing age and they want to turn back the clock a few years. These patients generally have a combination of moderate thickening of tissue in the upper arm ad moderately loose skin. Depending on the amount of skin looseness, the incision to remove some of the skin can be completely hidden in the armpit crease or it may have to extend a short distance down the arm. Again, this procedure is very reliable and produces excellent results to a point where wearing of T-shirts is no longer an embarrassing chore. Depending on the extent of the incisions, you may need a few days off work although it can still be performed as a day surgery operation.

The third type of problem I will see is the patient who has lost a significant amount of weight and can be of any age and either sex. Major weight loss will result in stretching of the skin and skin redundancy when the weight has been lost. Generally, these patients suffer form major embarrassment and will now show their arms at all. In this situation, the incision usually has to extend down the inside of the arm to the elbow. The hairline scar is a small price to pay for a thinner, well-contoured arm which will look great even in short sleeves.The recovery time is around a week before you can go back to work (depending on your job).

Initial Consultation

During the initial consultation, you may be asked to point out exactly what you would like to see improved. This will help your plastic surgeon to understand your expectations and determine whether they can be realistically achieved.

You will be asked about your medical history including previous operations, past and present medical conditions and current medications. In order to provide you with the best information and safest options, it is important that you give your surgeon complete information. The medical conditions that may increase risks of surgery include high blood pressure, thyroid problems, diabetes and bleeding problems.

Your plastic surgeon may examine your arm while you are standing as well as lying down. Your skin tone and the degree of loose skin in the arm region will be assessed. Your surgeon also will evaluate the amount of excess fat in your arm.

Preoperative photographs may be taken during your initial consultation or a subsequent visit. Your surgeon will discuss with you the details of the operation and the possible risks and complications associated with the procedure.

Preparation For Surgery

The goal of your plastic surgeon and the staff is to make your surgi cal exper ience as easy and comfortable for you as possible. Smokers will be asked to stop smoking 3 weeks before surgery. Aspirin and some anti-inflammatory drugs used for the treatment of arthritis can cause increased bleeding, so you should avoid taking these medications for 2 weeks before surgery. Arm lift is usually performed in a hospital under general anaesthetic and you can expect several days’ stay.

The day of Surgery

Your surgeon will mark your skin before the operation and if you have not already done so, you will need to sign the consent form for your operation. Medications are administered for your comfort during the surgical procedure. During the anaesthetic, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

Your Operation

Because of individual factors, not everyone will achieve the same results from arm lift. Your plastic surgeon will select the surgical technique that he or she feels will obtain the best outcome for you. Inci s ion l ines wi l l fade over t ime but wi l l be permanently visible. Arm lift incisions usually can be placed in locations concealed by bathing suits and undergarments.

Arm lift can be combined with other procedures, such as liposuction of the flanks, outer arms and/ or arms.

Where will the incisions be?

The usual placement of the incisions follows the armpit crease, around the junction of the inner arm and the armpi t . The exact inci s ion will vary somewhat according to the shape of your arm. Depending on the amount of tissue you have, the scar may be limited to the armpit only or it may extend some way down the arm. This may be halfway down, or as far as the elbow. The exact extent of the incision will be decided between you and your surgeon.

Sometimes liposuction may be used alone, or in conjunction with arm lift, to remove arm fat. How long does the operation take? The operation takes 1 ½ to 3 hours, depending on the extent of each operation.

After Surgery

When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. You will have a firm arm bandage or a compression garment, which you will have to keep on for 3-6 weeks after surgery as instructed by your surgeon.

You will feel drowsy for several hours after the procedure and you will remember very little of this time.

How will I look and feel initially?

It is important to realize that the amount of time it takes for recovery varies greatly among individuals and also depends on the extent of the operation. The stitches are usually hidden beneath the skin so that no sutures need to be removed following surgery.

You will notice swelling and bruising, which is to be expected. The bruising and much of the swelling will disappear over a period of weeks. However, it may be months before all swelling subsides and you see the final result of your arm lift. You may also notice some numbness over portions of the arm area, and this may persist for several months. Incisions will initially be red or pink in colour. They will remain this way for many months following surgery and may even appear to worsen before they finally begin to fade.

Some numbness around the suture line may persist for months after surgery. The arm skin may feel quite tight for some time but this feeling will gradually lessen and relax. This s due to strong stitches holding up the arm skin and keeping it anchored to the strong tendons around the armpit.

When can I resume my normal activities?

You may be able to return to light work anywhere from one to three weeks after surgery. In many instances, you can resume most of your normal activities, including some form of mild exercise, after several weeks. You may continue to experience some mild, periodic discomfort and swelling during this time, but such feelings are normal. Severe pain should be reported to your doctor.

Results of your Surgery

Since the healing process is gradual, you should expect to wait at least several weeks to get an accurate picture of the results of your surgery. Incisions will fade over a number of months.

Unless you gain or lose a significant amount of weight or become pregnant, your arm should remain firmer and flatter for many years. However, gravity and the effects of ageing will eventually take their tol l . I f , af ter a per iod of year s , you become dissatisfied with the appearance of your arm, you may choose to undergo a second procedure to restore a more youthful arm contour.

Results of your Surgery

Fortunately, significant complications from arm lift surgery are infrequent. Every year, many operations are performed with no major problems and good results. However, everyone considering surgery should be aware of both the benefits and risks. The subject of risks and potential complications of surger y is best discussed on a personal basis between you and your plastic surgeon. A number of measures will be in place to minimize the following risks:

• Bleeding may occur. At worst, this will require return to the operating theatre to evacuate the blood clot and to stop the bleeding.

• There will be bruising after surgery. This usually settles after approximately 2 weeks.

• Wound infection may complicate the operation in approximately 5% of operations. The infection is usually treated with antibiotics, oral or intravenous, depending on its severity.

• Dehiscence or reopening of the wound may occur in about 1-5 percent of operations. This usually happens as a result of infection and is managed by treating the infection.

• Collection of blood or fluid under the operated skin. Because arm lift is usually an extensive operation, blood can collect under the repositioned arm skin. This usually happens within the first 24 hours after surgery. Rarely, it may require return to the operating theatre. More commonly, fluid collects under the skin without any obvious ill effects. Removal of this serum is a painless process but may require several visits to the plastic surgeon's office.

• Skin loss in the highest extent of the repositioned arm skin occurs in approximately 2% of operations. This complication is more common in smokers and it is therefore very important that you stop smoking at least two weeks before surgery. Skin loss is also more common in medical conditions such as diabetes.

• Fat underneath the skin may not survive surgery and oily discharge may persist from the wounds for some weeks after surgery.

• Arm lift may result in long scars. Wide, lumpy or irregular scars may occur due to the tension on the tissues after surgery. Revisionary surgery is sometimes helpful in certain instances where incisions may have healed poorly.

• The scar, which is designed to lie in the creases along the top of the arm, may descend in to the upper arm under the action of gravity. This means that the scar may, with time, no longer be hidden within creases and may be more visible.

• There may be numbness in the upper part of your arm skin after surgery. This usually recovers with time.

• Blood clots in arm veins may cause arm swelling. The clots may travel to the lungs causing severe breathing difficulty and, rarely, death. With adequate precautions, which are routinely taken, including medications, compression stockings and early mobilization, these complications are uncommon.

You can help to minimize certain risks by following the advice and instructions of your plastic surgeon, both before and after your surgery.

Maintaining a relationship with your Plastic Surgeon

Should there be any questions regarding arm lift; be sure they are answered in advance. Well meaning friends are not a good source of information. Find out everything before proceeding with the operation - a well informed patient is a happy one.

After surgery, you will return to your plastic surgeon's office for follow-up care at prescribed inter vals, at which time your progress can be evaluated. Post-operative photographs will form a part of the evaluation of your result. Once the immediate postoperative follow-up is complete, many surgeons encourage their patients to come back for periodic check-ups to observe and discuss the longterm results of surgery.

Please remember that the relationship with your plastic surgeon does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact your surgeon.

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