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Body Contouring (post bariatric surgery) Face Breast Body Non-Invasive

Body Contouring - Brachioplasty (Arm Lift)

Arm Lift Iowa | Brachioplasty IowaPatients who present with upper arm excess often complain of feeling like they have "bat wings". Most often these patients had been overweight and have lost a significant amount of weight leading to a deflation of the upper arm.

In a few patients the skin of the upper arm will contract back to its original size, like a balloon that has been blown up for a short time and after the air is let out of it, it goes back to its original size, a small tight balloon.

Unfortunately upper arm skin most often will not contract after massive weight loss and will act like a balloon that has been over inflated for a long time leading to a loose balloon that hangs after deflation.


Notice: This section contains graphic medical images.

 

Arm Lift, Upper Arm Lift

Careful examination of most massive weight loss patients' arms reveals that their upper arm excess does not end in the armpit, but goes on to the chest wall, see Figure 1.

 

Arm Lift Iowa | Brachioplasty Iowa

Figure 1. The upper arm deformity associated with massive weight loss is very well demonstrated in this patient. Note that the excess of the upper arm spills onto the outer chest wall.

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More traditional arm reduction techniques, called brachioplasty, limit the removal of tissue to the upper arm and armpit (axilla). This will often lead to inadequate removal of excess tissue and less than optimal results.

We have developed a technique that takes into account the excess that spills onto the chest wall and allows for more trimming of tissue in the upper arm. The markings, which are made prior to surgery to estimate the amount of tissue to removed are shown in Figures 2,3,4.

 

Arm Lift Iowa | Brachioplasty Iowa

Figure 2. This massive weight loss patient shows the markings utilized at the time of surgery to reduce upper arm excess. Note the large ellipse with cross hatch marks that will be removed, starts at the elbow, goes up to the arm pit, and then onto the chest wall. This technique has greatly enhanced our ability to improve upper arm contour as can be seen in this patient's before and after photographs shown in figures 3 & 4.

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Arm Lift Iowa | Brachioplasty Iowa

Figure 3. This is the same patient shown in figure 2, frontal view, shown before (above) and after (below) undergoing brachioplasty, or upper arm reduction surgery utilizing the technique discussed.

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Arm Lift Iowa | Brachioplasty Iowa

Figure 4. This is the same patient shown in figure 2, back view, shown before (above) and after(below) undergoing brachioplasty, or upper arm reduction surgery utilizing the technique discussed.

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This technique eliminates excess chest wall tissues at the same time that it improves the arms. It is part of another method we developed, an "upper body lift", which is designed to rejuvenate the entire chest area, including the arms.

The ideal candidate for the arm reduction technique we utilize is someone who has "bat wings" with minimal to moderate fat remaining in the upper arms. If the upper arms still retain a significant amount of fat when the patient presents to us, then we must deflate them with a preliminary liposuction procedure, where the fat is suctioned out through small incisions and the arm is allowed to heal for about 6 months. The second procedure is identical to what would be performed if the patient presented with minimal to moderate fat.

The upper arm reduction procedure is performed under a general anesthetic. An ellipse is drawn on the inside of the arm that goes onto the chest wall, see figure 2. The ellipse of tissue is then removed and the tissues are re-approximated in a straight line except for a zig-zag in the armpit. One or two drains, tubes that drain body fluids and blood, are usually inserted and removed within a few days after surgery. The procedure usually takes 2 to 3 hours to perform by our two-surgeon team.

After surgery the patient's arms are elevated to help reduce swelling. This is usually required for 3 to 6 weeks. Scaring in the upper arms is less than ideal and often these scars can be hard and raised. They may or may not be wide, see Figure 5.


Arm Lift Iowa | Brachioplasty Iowa

Figure 5. This massive weight loss patient is shown before, above, and after, below, after brachioplasty, or an upper arm lift. Although the contour improvement is excellent, note the scaring in this area of the body can be fairly thick and raised. Often the color will blend in as time passes, but thin and barely visible scars in this area are the exception, rather than the rule.

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As with any surgery, complications can and do occur. The patient should weigh these risks with the benefits before proceeding with surgery. Those risks include, but are not limited to infection, bleeding, bad scarring, temporary and permanent numbness, temporary and permanent swelling or lymphedema, wounds coming apart, seromas or fluid collections, possible need for revisions, nerve compression causing difficulty with movement of the arm and hand, and possible need for skin grafting.

As with the other massive weight loss surgery we perform, we operate on many out-of-town patients. For those patients similar provisions are made for brachioplasty, or upper arm lift patients, as those made for the belt lipectomy patients.

The following figures are a few more examples of the upper arm reduction surgery method that we prefer to utilize.


Arm Lift Iowa | Brachioplasty Iowa

Arm Lift Iowa | Brachioplasty Iowa

Arm Lift Iowa | Brachioplasty Iowa

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Plastic Surgery Iowa Dr Albert E Cram | Plastic Surgeon | Iowa