Pros and Cons of Different Brachioplasty Procedures

If there is one thing to understand about brachioplasty (arm lift surgery), it’s that the operation always leaves a scar. Different techniques involve different incision placements, which means the scar can vary significantly in length, visibility, and location. Some methods leave a relatively short scar, while others require a longer incision in order to achieve the desired tightening.

In this article, Dr Bernard Beldholm, FRACS, explains what kind of scarring to expect with different types of brachioplasty procedures. He will also outline the main advantages and disadvantages of each technique so you can make an informed choice before undergoing surgery.

By the end, you will have a clearer idea of the benefits, trade-offs, and scarring associated with each method of arm reduction surgery. This helps ensure there are no surprises after your operation.

General Pros and Cons of Brachioplasty

Every surgical procedure has both benefits and drawbacks. A brachioplasty is no exception.

Advantages:

• Reshapes and tightens the arm contour, creating a firmer appearance
• Removes excess fat and redundant skin that does not respond to diet or exercise
• Results may last for many years if you maintain a healthy, stable weight

Disadvantages:

• All surgical procedures carry risks, such as bleeding, infection, or wound healing problems
• A brachioplasty always leaves a permanent scar on the arms
• Scars can vary in visibility, but some may remain noticeable in short sleeves or sleeveless clothing

How Scar Length is Determined

The type of incision – and therefore the scar – depends on the following factors:

• Amount of excess tissue: Larger amounts of loose skin usually require longer incisions.
• Location of the laxity: Some patients have skin only near the armpit, while others have tissue extending from the armpit to the elbow or even onto the chest wall.
• Desired outcome: The more dramatic the tightening required, the longer the incision is likely to be.

Dr Beldholm will examine these factors during your consultation and recommend the surgical plan that best matches your anatomy and goals.

Comparison of Different Brachioplasty Procedures

Mini Brachioplasty: Pros and Cons

How it works

A mini brachioplasty, also known as a limited incision brachioplasty, involves a short incision placed in the natural crease of the armpit (axilla). A small segment of excess skin and fat is removed, and the remaining skin is drawn upward toward the armpit.

Possible Benefits:

• Scar is hidden in the armpit, making it less visible in most clothing
• Shorter recovery time compared to other methods, as the incision is small
• Useful for patients with only mild to moderate laxity near the upper arm and armpit

Possible Disadvantages:

• Less dramatic results than full or extended brachioplasty
• Not suitable for massive weight loss patients or those with extensive skin redundancy
• May not address laxity extending toward the elbow or chest wall

Full Brachioplasty: Pros and Cons

How it works
A full brachioplasty is the most common option, particularly for patients who have undergone significant weight loss. The surgeon places a vertical incision along the inner or back of the arm, typically extending from the elbow to the armpit. Excess skin and underlying fat are removed, and the arm is reshaped.

Possible Benefits:

• Achieves more dramatic tightening than a mini brachioplasty
• Effective for patients with moderate to severe skin laxity
• Produces a more defined arm shape

Possible Disadvantages:

• A scar is longer and usually visible in short sleeves and singlets
• Healing time is longer compared to a mini brachioplasty
• May require diligent scar management for the best cosmetic result

Extended Brachioplasty: Pros and Cons

How it works
An extended brachioplasty addresses not only the upper arms but also the sides of the chest wall. The incision begins at the elbow, runs through the armpit, and continues down onto the lateral chest area. This allows removal of the greatest amount of redundant skin.

Possible Benefits:

• Provides the most comprehensive result, tightening both arms and the lateral chest
• Often the most suitable option for patients after massive weight loss
• Can dramatically reduce excess tissue and improve overall upper body contour

Possible Disadvantages:

• The longest scar of all brachioplasty procedures, extending from the arms onto the chest
• Longer recovery time due to the larger surgical field
• Scar visibility is higher, particularly in swimwear or sleeveless clothing

Scar Care and Healing

After surgery, scars typically go through a maturation process that can take 12 to 18 months. While they may fade into a fine line, some individuals are prone to hypertrophic or keloid scarring.

Ways to support scar healing include:

• Avoiding direct sun exposure on fresh scars
• Using silicone gel or prescribed creams as directed
• Considering laser scar therapy, which Dr Beldholm includes in his follow-up care
• Wearing compression garments to support wound healing and minimise swelling

Scars can improve with time, but they will always be present to some degree. Patients must weigh the benefit of tighter arms against the trade-off of permanent scarring.

Final Thoughts

Choosing between a mini, full, or extended brachioplasty involves balancing the results you want with the scar you are prepared to accept. Each method has unique benefits and disadvantages, which Dr Beldholm will explain in detail during your consultation.

By understanding the pros and cons of each option in advance, you can make a confident and well-informed decision about your surgery.