WHAT IS A BRACHIOPLASTY?

A brachioplasty, also known as an arm lift, is a surgical procedure that aims to improve the appearance of the arms by removing excess skin.
Excess skin of the upper arms can occur as a result of weight loss, aging, or a combination of both. Of course, for some patients, there may also be a hereditary component. Regardless of the cause, if loose skin and fuller upper arms are a problem area for you, then this kind of surgery can help.
Brachioplasty is different from upper arm liposuction, although there is almost always a degree of liposuction that goes with every brachioplasty. The key component of a Brachioplasty (Arm Lift) is the resection of the skin along the lower/inner border of the upper arm and the associated scar that accompanies it.
By tightening and reshaping the arm area, brachioplasty can provide functional relief for patients who experience discomfort from excess skin, as well as the aesthetic benefit of a more balanced silhouette.

WHO ARE THE BEST CANDIDATES FOR A BRACHIOPLASTY?

The ideal patient for a brachioplasty (arm lift) is someone who has reached close to their ideal weight and has maintained this and has loose upper arm skin. It is not a procedure for weight loss but may best be thought of as one that involves the careful tailoring of the loose skin. It is often combined with some liposuction at the same time.

WHAT ARE THE IDEAL OUTCOMES FOR THE PATIENT?

The ideal outcome for patients to is to have tapered and contoured upper arms again without the characteristic loose skin that accompanies massive weight loss. Patients often come to me complaining that they are frustrated that they have lost a large amount of weight, but the skin just won’t retract down to the normal state. Unfortunately, the upper arm is quite unforgiving in this regard, and often the only thing to truly address this problem is a brachioplasty.

WHAT ARE THE MAIN reasons for a brachioplasty?

TO REMOVE EXCESS FAT AND SKIN

The upper arms can be especially problematic for those who have recently lost a lot of weight. Because fat stores itself in this area, when the fat is lost, the skin almost always remains baggy. This can make it hard to tell that the weight was lost at all.
One of the most common complaints among those who recover from bariatric procedures meant to help with weight loss is that after the weight rapidly comes off, the skin on the arms sags and can appear unsightly. Many choose to follow up on their bariatric procedures with Brachioplasty as a final step in achieving their body image goals.

TO IMPROVE CONTOUR

Well-defined, shapely arms are appealing no matter who you are. Improving the contour and definition of the upper arm through Brachioplasty will add aesthetic appeal more easily than through other alternative methods of toning the area.
The tone and shape of your arms can be changed using Brachioplasty. Depending on how the physician chooses to tuck the skin and trim away excess deposits of fat, the appearance of your upper arm can actually be altered rather dramatically.
This is a particularly appealing option for those who have always felt self-conscious about how their genetics have determined the shape of the arm between the shoulder and elbow. Genetic shaping is usually not responsive to other factors, so Brachioplasty provides a rare chance to create options.

TO ACHIEVE BETTER PROPORTIONING

One of the biggest complaints people have about the shape of their arms is that the upper arm can seem disproportionately large when compared to the forearm. If you feel that your arms are not properly proportioned, Brachioplasty may be a solution.
During this procedure, the upper arm is trimmed and tightened to create a more proportionate look when compared to the rest of the arm and shoulder. When the proportions of your arm seem more correct, it will usually be easier for you to maintain confidence in your overall appearance.

TO REMOVE SCAR TISSUE

Sometimes your upper arm can have scars or other cosmetic issues that are the result of past injury or skin irritations earlier in life. In these circumstances, Brachioplasty can offer an opportunity to minimize these issues. During Brachioplasty, the skin is trimmed and tucked in a way that offers minimization of other cosmetic imperfections.

TO ADDRESS HYGIENE ISSUES

Depending on how much excess skin you are trying to manage, you might find that there are certain hygiene issues that are involved. Issues like rash and sweat irritation or yeast infection can occur in areas where there are excess folds that lock in moisture or are hard to clean.
Brachioplasty can help you overcome these issues by removing the excess skin that is creating a problematic environment in terms of overall cleanliness.

TO IMPROVE YOUR OVERALL PHYSICAL COMFORT

Much like wearing clothing that is oversized, the issues involved in carrying excess skin can be uncomfortable. You might feel pinching or general discomfort when your arms are tucked inside or your clothing. Even sleeping can present problems if the skin folds in an uncomfortable way.
Brachioplasty can remove these areas of excess skin and help you feel more comfortable, reducing the discomfort that is often associated with excessive folds or wrinkling in relation to sagging skin in the upper arm area.

TO GAIN CONFIDENCE

The upper arm is often a place that creates a sense of low self-esteem. If someone is uncomfortable with how they look, it is hard to feel confident. The fastest way to overcome these feelings is to find a way to feel better about how you look.

FREQUENTLY ASKED QUESTIONS ABOUT BRACHIOPLASTY surgery

IS BRACHIOPLASTY (ARM LIFT) DIFFERENT FROM UPPER ARM LIPOSUCTION?

Brachioplasty is different from upper arm liposuction although there is almost always a degree of liposuction that goes with every brachioplasty. The key component of a brachioplasty is the resection of the skin along the lower/inner border of the upper arm and the associated scar that accompanies it.

WHAT COMPLICATIONS ARE INVOLVED? (WHERE ARE INCISIONS PLACED, AND WHERE DO SCARS FORM)

The big trade-off with Brachioplasty is the scars. If a massive result is expected then often this is unachievable without some kind of skin excision. Most incisions are placed either on the inside or behind the upper arm. I prefer to place my incision somewhere in between and feel this is difficult to see for both the patient and those around them. There are certain areas on the body that are prone to more visible scars and the upper arm is unfortunately one of them. It has been my experience that the scars are much better when placed toward the back rather than the inside of the arm. The other major complication can be injury to the lymphatics which is also minimised with a more posterior approach. Temporary and potentially permanent sensory changes to nerves on the inside of the arm can also occur but are fortunately rare.

WHAT IS THE DOWNTIME AND POST-OP CARE INVOLVED?

It all depends on the type of brachioplasty performed but on average the downtime is 2 weeks. There are drains in the initial post-operative period that are removed after only a few days. All the sutures are internal and do not require removal. Patients can shower normally after the first day. They can also expect to have some from compression garments for 6 weeks after the operation and will have scar management therapy throughout. The reintroduction of upper arm exercise programs has to be taken slowly and I would advise to commence slowly after 4 weeks.

Risks and complications of cosmetic surgery

Cosmetic surgery is still surgery and as such always has potential risks and complication. It is important for anyone considering cosmetic surgery to be well-informed and aware of the possible adverse outcomes. Dr Alex Phoon is a fully qualified Australian specialist plastic and cosmetic surgeon who operates with an experienced team in leading public and private hospitals in Sydney Australia.
In this article, we will dive into the various risks and complications associated with cosmetic surgery, providing insights into each aspect.

Scarring

One of the most common concerns among patients undergoing cosmetic surgery is the potential for scarring. While skilled surgeons strive to minimize scarring, it is an inevitable part of the healing process.

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The severity of scarring varies depending on the individual and the procedure performed. Certain factors, such as genetics and skin type, can also influence how prominent scars may be. However, it is worth noting that in many cases, scars fade over time and can be further improved through scar revision techniques.

Scarring is a natural part of the body’s healing process. When the skin is injured, whether through surgery or trauma, the body responds by forming new collagen fibres to repair the damage. This process can result in the formation of a scar, which is a visible mark on the skin that differs in texture and colour from the surrounding tissue.

There are different types of scars that can occur after cosmetic surgery. One common type is a hypertrophic scar, which is characterized by raised and thickened tissue. These scars may be red or pink in colour and can be itchy or uncomfortable. Another type of scar is a keloid, which is an overgrowth of scar tissue that extends beyond the boundaries of the original wound. Keloids are more common in individuals with darker skin tones and can be more challenging to treat.

Fortunately, advancements in surgical techniques and post-operative care have greatly improved the management of scars. Surgeons take great care in placing incisions in inconspicuous areas and using techniques to minimize tension on the wound, which can help reduce the risk of visible scarring. Additionally, patients are often advised to follow a specific scar care regimen, which may include keeping the incision site clean, applying silicone gel or sheets, and avoiding sun exposure.

In some cases, scar revision techniques may be recommended to further improve the appearance of scars. These techniques can include laser resurfacing, dermabrasion, or surgical excision. Laser resurfacing uses a laser to remove the top layers of the skin, promoting the growth of new, healthier skin cells. Dermabrasion involves using a rotating brush or diamond wheel to gently remove the outer layers of the skin, revealing smoother skin underneath. Surgical excision involves removing the scar tissue and rejoining the edges of the skin to create a more aesthetically pleasing scar.

It is important for patients to have realistic expectations when it comes to scarring. While surgeons strive to minimize scarring, it is impossible to eliminate it. However, with proper care and the use of scar revision techniques, the appearance of scars can be significantly improved. Patients should discuss their concerns and expectations with their surgeon prior to undergoing any cosmetic procedure to ensure they have a clear understanding of the potential for scarring and the available treatment options.

Infection

Infections are another risk associated with any surgical procedure, including cosmetic surgery. Despite stringent sterilization protocols followed by healthcare professionals, there is still a possibility of infection.

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To mitigate this risk, surgeons prescribe antibiotics pre- and post-surgery, adhere to aseptic techniques, and closely monitor patients for signs of infection. It is crucial for patients to follow their surgeon’s aftercare instructions to minimize the risk of infection.

When it comes to cosmetic surgery, infection is a concern that cannot be ignored. Surgical procedures, no matter how minor, create an entry point for bacteria and other microorganisms. Although healthcare professionals take every precaution to maintain a sterile environment, the human body is naturally teeming with bacteria, making it impossible to eliminate the risk entirely.

Fortunately, surgeons are aware of this risk and take proactive measures to minimize the chances of infection. One such measure is the prescription of antibiotics. Prior to surgery, patients are often given a course of antibiotics to help prevent any potential infection from taking hold. These antibiotics are carefully chosen based on the patient’s medical history and the specific procedure being performed.

Post-surgery, patients are usually required to continue taking antibiotics for a certain period. This helps to ensure that any bacteria that may have entered the body during the procedure are promptly eradicated. By adhering to the prescribed antibiotic regimen, patients can significantly reduce the risk of developing an infection.

In addition to antibiotics, surgeons also follow strict aseptic techniques during the surgical procedure itself. This involves maintaining a sterile environment, using sterile instruments and equipment, and wearing appropriate protective clothing, such as gloves and masks. These precautions help to minimize the introduction of bacteria into the surgical site, further reducing the risk of infection.

Despite these measures, it is important to note that infections can still occur. The human body is a complex system, and sometimes even the most stringent precautions cannot completely eliminate the risk. However, by closely monitoring patients for signs of infection, surgeons can detect and treat any potential infections early on, preventing them from becoming serious complications.

Patients also play a crucial role in minimizing the risk of infection. Following the surgeon’s aftercare instructions is of utmost importance. This may include keeping the surgical site clean and dry, avoiding certain activities or behaviours that could increase the risk of infection, and promptly reporting any signs of infection, such as redness, swelling, or discharge.

In conclusion, while the risk of infection is present in any surgical procedure, including cosmetic surgery, healthcare professionals take numerous precautions to minimize this risk. From prescribing antibiotics to following aseptic techniques, surgeons prioritize patient safety and strive to create the best possible outcome. However, it is essential for patients to actively participate in their own aftercare and follow the instructions provided by their surgeon to further reduce the risk of infection.

Pain

Pain and discomfort is a common experience following cosmetic surgery but can be mitigated with modern analgesic strategies.

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The extent of pain can vary depending on the procedure, the individual’s pain tolerance, and the body’s healing response. Surgeons typically prescribe pain medications to manage any discomfort during the recovery period. It is important for patients to communicate their pain levels with their healthcare providers, as proper pain management is crucial for a smooth recovery.

Undesirable cosmetic outcome

While cosmetic surgery aims to enhance aesthetics, there is always a risk of an undesirable cosmetic outcome.

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Factors such as unrealistic expectations and the biological unpredictability of healing can contribute to suboptimal results. It is essential for patients to have open and honest discussions with their surgeons about their desired outcomes, potential limitations, and realistic expectations. This helps ensure that both parties are on the same page and reduces the chances of disappointment. Revision surgery might be an option should this be an issue.

Nerve damage

Another potential complication of cosmetic surgery is nerve damage.

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Surgeons take great care to avoid damaging nerves during procedures, but it is not always possible to eliminate this risk entirely. Nerve damage can cause numbness, tingling, or loss of sensation in the operated area. In most cases, nerve function gradually improves, but it may take some time for complete resolution. Patients should be aware of this potential risk and discuss it with their surgeon before proceeding with the surgery.

Bruising and swelling

Bruising and swelling are common after cosmetic surgery, particularly in the early stages of recovery.

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These symptoms are part of the body’s natural response to trauma. Surgeons may recommend compression garments, elevation, and cold compresses to help minimize these effects. While bruising and swelling are temporary, they can cause discomfort and can affect the recovery timeline. Patience and adherence to post-operative guidelines can aid in reducing the duration and severity of these side effects.

Bleeding

Bleeding during or after surgery is a potential complication that can occur in any surgical procedure, including cosmetic surgery.

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Surgeons take measures to control bleeding during the operation, but occasionally, some post-operative bleeding may occur. It is crucial for patients to inform their healthcare providers if they experience excessive bleeding or if they are unable to control bleeding with gentle pressure. Immediate medical attention is necessary to address this complication. If there is major bleeding, you might require a blood transfer or transfer to a hospital for additional treatment.

Seroma

A seroma is a pocket of fluid that can accumulate under the skin after surgery.

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It forms as a result of the body’s inflammatory response. Seromas are more common in larger surgical procedures and can lead to swelling and discomfort. Surgeons may drain seromas through aspiration or place drains to prevent their accumulation. A surgical drain can be used to minimise this risk. Close monitoring by healthcare providers is crucial to ensure the timely detection and management of seromas.

Anaesthetic complications

Although rare, complications related to anaesthesia can occur during cosmetic surgery.

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Anaesthesia is administered to ensure patient comfort and safety during the procedure. Factors such as individual reactions, allergies, or underlying health conditions can increase the risk of complications. Anaesthetists are highly trained professionals who monitor patients closely throughout the surgery to minimize any potential risks.

Death

While the risk of death from cosmetic surgery is extremely low, it is essential to acknowledge that any surgical procedure carries inherent risks.

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Every effort is made to prioritize patient safety and ensure favourable outcomes. The preoperative assessment, careful surgical planning, and adherence to appropriate protocols help minimize this risk. Patients should discuss their specific concerns with their surgical team and feel confident in the expertise and experience of their chosen surgeon.

In conclusion, cosmetic surgery offers individuals an opportunity to enhance their appearance, but it is essential to recognize that it is not without its risks and complications. By understanding and discussing these potential outcomes with their surgeons, patients can make informed decisions and take necessary precautions to optimize their safety and overall surgical experience. With proper expectations, diligent aftercare, and open communication, the risks associated with cosmetic surgery can be minimized, and the goal of achieving desired aesthetic improvements can be realized.

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