Brachioplasty Techniques: Which One is Right for You?

Brachioplasty (arm lift surgery) is a surgical procedure designed to remove excess skin and fat from the upper arms. This operation can help improve the appearance of the arms in people who have loose skin due to ageing, weight loss, or genetics. In this article, Dr Bernard Beldholm, FRACS, explains the different types of brachioplasty procedures, who may benefit from them, and what to expect during the consultation and planning process.

Face blurred for privacy

Disclaimer: Surgery performed by Dr Beldholm. Adult content, Results vary, seek 2nd opinion, Surgery has risks – See full disclaimer

What Causes Loss of Skin Elasticity in the Upper Arms?

Skin changes naturally over time. As collagen and elastin production decline with age, the skin becomes less resilient. In the upper arms, this can lead to noticeable looseness.

Another common reason for loose arm skin is significant weight loss. When fat is lost, the skin may not fully contract back, leaving extra tissue behind. This is particularly common in people who once carried more weight in their arms.

How Can Brachioplasty Help?

Brachioplasty (arm lift surgery) addresses these changes by surgically removing loose skin and underlying fat. The procedure involves creating an incision on the arm, excising excess tissue, and tightening the remaining skin. The aim is to provide a firmer, smoother arm appearance.

Who is a Candidate for Brachioplasty Surgery?

The Massive Weight Loss Patient

After major weight loss, patients often have excess skin that no amount of diet or exercise will resolve. When the loose tissue is concentrated on the upper arms, brachioplasty may be appropriate.

The Mature Patient

As ageing reduces skin elasticity, the upper arms can develop sagging tissue. Brachioplasty can help make the arms appear tighter by removing this excess skin.

The Patient with Localised Arm Fat

Some individuals carry more fat in the arms despite being at a healthy weight. If the skin is still firm, suction-assisted lipectomy (liposuction) alone may be considered. If there is loose skin as well, brachioplasty combined with fat reduction may be an option.

Do I Need a Referral to Speak to a Surgeon?

Since July 2023, Australians seeking cosmetic surgery procedures, including brachioplasty (arm lift surgery), require a referral from their GP. Your GP will check your physical and mental health before you are referred to a specialist surgeon.

Brachioplasty Consultation: Determining the Right Technique

During a consultation, Dr Beldholm will:

• Ask about your concerns, both aesthetic and functional. Some people want improvement in appearance, while others experience chafing or discomfort from excess skin.
• Perform an examination and take clinical photographs to help assess how much skin needs removal.
• Review your medical history and lifestyle, including smoking status and weight stability.

This process ensures the operation is safe and tailored to your individual needs.

Types of Brachioplasty Procedures

Short Scar Brachioplasty (Mini Brachioplasty)

This technique uses an incision hidden in the armpit to remove a small amount of excess skin. It is best suited for patients with mild skin laxity, often related to ageing or minor weight loss. However, it does not address significant amounts of loose skin.

Standard Brachioplasty (Elbow to Armpit Incision)

A standard brachioplasty uses a longer incision that runs from the elbow to the armpit. This allows for removal of a greater amount of skin and fat. The scar is typically placed along the inner arm where it is less visible when the arms are at the side. Other options include anterior or posterior scar placement, which may be less discreet.

Extended Brachioplasty (Elbow to Chest Wall)

For patients who have lost a substantial amount of weight, the extended technique may be required. The incision begins at the elbow, continues through the armpit, and extends onto the side of the chest wall. This allows removal of excess tissue not only on the arms but also along the chest sides.

Combining Suction-Assisted Lipectomy (Liposuction) with Brachioplasty

In many cases, brachioplasty (arm lift surgery) focuses on removing loose skin from the upper arms. However, some patients also have areas of excess fat in the arms. To address this, suction-assisted lipectomy (liposuction) can be performed at the same time as brachioplasty.

By combining these two procedures, Dr Beldholm can remove both extra fat and excess skin. The suction-assisted lipectomy reduces fatty tissue, while the brachioplasty excises loose skin and tightens the remaining tissue. This approach may be particularly useful for patients who have lost a large amount of weight, or for those who have both skin laxity and localised fat in the upper arms.

If a patient has good skin elasticity and only excess fat, suction-assisted lipectomy alone may be an option. But when there is significant skin laxity, brachioplasty with fat reduction may provide a more complete solution.

Preparing for Brachioplasty Surgery

Before having surgery, there are several factors to consider:

• Stable weight: Achieve and maintain a stable weight for at least six months. Ongoing fluctuations may cause skin laxity to return.
• Smoking: Quit smoking several weeks before and after surgery, as nicotine increases the risk of complications.
• Pregnancy and breastfeeding: Surgery is not recommended if you are pregnant or breastfeeding.
• Healthy lifestyle: Long-term commitment to good nutrition and exercise helps preserve the results of surgery.

Next Steps

If you meet the requirements for brachioplasty and are considering the procedure, the next step is to obtain a referral from your GP. A consultation with Dr Beldholm will allow you to explore the surgical options available, and together you can plan the most suitable technique for your needs.