What is brachioplasty?

A brachioplasty is a surgical procedure that reshapes the back part and the under surface of your upper arm, from your shoulder to your elbow. It’s also called an arm lift. It gets rid of extra skin and fatty tissue. It makes your upper arm look smoother and smaller.

When you gain a lot of weight, your skin slowly stretches over time. If you lose a lot of weight, as you get older your skin may not have enough elasticity to spring back into place. This can lead to extra skin folds and sagging of tissue. These are likely to be under your arm and chin, and on your upper thighs and lower stomach. These changes may happen after you have lost a lot of weight from weight-loss surgery.

Brachioplasty is a type of body-contouring surgery. This type of surgery is often done after weight-loss surgery. Many people who have had weight-loss surgery are interested in reshaping surgeries. Surgeons often do brachioplasty at the same time as another surgery. These may include body contouring around the midsection, under the chin, or along the inner thighs.

During this surgery, a plastic, cosmetic, or aesthetic surgeon takes out areas of extra tissue from under your upper arm. Your surgeon will make a cut on the inside or back of your arm. They may do liposuction on the area. They will remove extra folds of skin and fat. Your surgeon will then sew the tissue that is left back together. This creates a smoother contour. This may also improve muscle tone in your upper arm. Sometimes the surgeon also removes extra tissue on the side of the chest. This results in a longer scar.

You will likely be asleep under general anesthesia during this surgery.

Why might I need a brachioplasty?

This surgery may be for you if you recently lost a lot of weight. It’s often done after weight-loss surgery. You may not be happy with how you look after weight-loss surgery if you have extra folds of tissue under your arm. You may also notice excess skin as you age.

These extra skin folds may cause the following problems:

• General discomfort

• Inflammation and rash. This can lead to an infection.

• Problems with hygiene in this area

• Poor self-esteem

What are the risks of brachioplasty?

In general, brachioplasty is a safe procedure. But all surgeries come with risks.

Your risks depend on your age, the amount of weight you lost, and other health issues you have. They also depend on your surgeon’s approach to surgery. Talk to your doctor about the risks that apply to you.

Possible risks can include:

• Trouble with wound healing.

• Infection

• Extra bleeding

• Damage to lymphatic tissue. This may cause swelling in your arm that may be permanent

• Damage to nearby nerves. This can cause short-term (temporary) or long-term (permanent) numbness.

• Complications from anesthesia

• Pain that doesn’t go away

• Blood clots, such as in the lung (pulmonary embolism)

• Skin looseness that comes back again and again

You may also not get the results that you want from the surgery. You may need to have another surgery to further contour the area of your upper arm.

You will also have a large, visible scar on your arm from the surgery. It may take time for the scar to fully develop. The scar may remain thick.

How do I get ready for a brachioplasty?

First, you should ask your healthcare provider if this surgery is right for you. If you have certain health issues, the risks of the surgery may outweigh the benefits. Your surgeon will also want to make sure that you have a realistic idea of the results of surgery. You will also need to commit to a healthy lifestyle and maintain a stable weight and stay generally fit.

Most health insurance plans won’t cover body-contouring surgery. They may cover it if you have a complication, such as an infection around a skinfold. These surgeries can be very expensive. Take a look at your finances. Talk with your plastic surgeon to find out how much it will cost you.

Don't have this surgery until you have reached a stable weight. If you lose weight after your surgery, you may get new areas where the skin can sag. If you gain a lot of weight after your brachioplasty, it can harm your weakened skin. This can cause stretch marks and wide scars.

If you smoke, you should quit smoking at least several weeks before your surgery. Smoking greatly increases the risk for complications.  Also ask your surgeon if you should stop taking any medicines before surgery. Ask about over-the-counter medicines, such as aspirin and blood thinners. Follow your surgeon's instructions about what to do before the surgery. For example, you may not be allowed to eat or drink anything after midnight before the day of your surgery. Also let your surgeon know about any recent health issues you’ve had, such as a fever.

Your surgeon may do testing before your surgery. These may include:

• Electrocardiogram to look at your heart rhythm

• Pulmonary function tests to check your lung function

• Basic blood tests to check for infection, anemia, and kidney function

Your surgeon may give you more instructions on how to prepare for your surgery.

What happens during a brachioplasty?

Your surgeon can explain the details of your surgery. Your surgeon and a team of nurses will do your surgery. In general, you can expect the following:

1. In most cases, you will get general anesthesia. This is to help you sleep through the operation. You won’t feel anything. Or you may get local anesthesia and a medicine that will keep you relaxed but awake.

2. The anesthesiologist will watch your heart rate, blood pressure, and other vital signs during the surgery.

3. You may get antibiotics during and after the procedure. This is to help prevent infection.

4. The surgeon makes a cut (incision) along the back of your arm or on the inside of your arm. It may go from your underarm to your elbow. Or the incision may go partly down your chest. They may do liposuction of the area.

5. The surgeon takes out extra skin and fat in this area and tightens and reshapes the underlying tissue. They may place a drain in the area to let extra blood or fluid drain. The incision is then closed.

6. The surgeon then reconnects the skin. This creates a smooth contour.

7. If planned, the surgeon will do another type of body-contouring surgery. You may have lipoosuction of your arm as part of your brachioplasty.

8. Dressings will be placed on your incisions.

What happens after a brachioplasty?

When you wake up, you may have a small, thin tube underneath your skin to drain fluid from the wound and the incision will be covered with dressings or bandages. Elastic bandages or a compression garment on your arm may be used to help keep the swelling down. You may also have some pain afterward. You can ask for pain medicine. You should be able to eat a normal diet as soon as you are ready for it.

You may need to stay overnight in the hospital. Some people can go home the same day as surgery. In that case, make sure someone can drive you home. You should also plan to have help after the surgery. It won’t be safe for you to drive for several days.

Your surgeon will tell you how to care for your incisions. It’s normal to have a little fluid drain from the incision site. Tell your surgeon if you have severe draining, redness, or a fever. Also tell your surgeon right away if you have severe symptoms. These include sudden shortness of breath or chest pain.

Your surgeon will tell you how much you can move after surgery. You should not put too much pressure on your incisions as they heal. Following your surgeon’s orders carefully will improve your chances of a smooth recovery.

You will see the results of your brachioplasty right away. They will last as long as you keep a stable weight. If you are not happy with the results of your surgery, talk with your surgeon. Some people need another surgery for best results.

Next steps

Before you agree to the test or procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how will you get the results

• Who to call after the test or procedure if you have questions or problems

• How much will you have to pay for the test or procedure