Arm lift surgery, otherwise known as brachioplasty, removes excess skin to reshape the upper arms and create a slimmer, more tightened, and better-contoured appearance.
Some people may have sagging skin anywhere from the armpit to the elbow area due to weight changes or natural aging. In severe cases, this is sometimes called a “bat wing.” Especially after significant weight loss, people can feel embarrassed and distressed about the appearance of their arms and avoid revealing their arms, even in hot weather.
People who seek an arm lift may have had significant weight loss or they may naturally have heavier arms. They may have tried to tone their arms through working out. Exercise and weight loss can improve the shape of your arms by reducing fat and increasing muscle tone, but it cannot change the appearance of loose and sagging skin. In these cases, surgery is the best option.
Arm-lift surgery is complex and should be carefully planned. An important first step is to choose a surgeon who has specialty training and experience in aesthetic plastic surgery.
A good surgeon will listen to your vision for your body and discuss which procedures will give a final result that will meet your goals.
Dr. Ginger Xu uses her high level of technical ability to make sure each person’s appearance aligns with their unique identity. Dr. Xu is a board-certified plastic surgeon with specialty training in aesthetic plastic surgery from Harvard. She is now based in the San Francisco Bay area.
Brachioplasty is the best treatment for “bat wings” or excess sagging skin on the upper arms. Upper arm skin can become loose and sag because of:
- Natural aging
- Weight changes
- Massive weight loss
- Inherited body type
Your surgeon will recommend a type of brachioplasty procedure based on the amount of sagging skin you have, your age, and your skin condition. Depending on the pre-existing condition of your arms, an arm lift can:
- Remove excess sagging skin and tissue in the underarm area from the armpit to the elbow
- Remove excess skin extending from the armpit area down the sides and around the chest after massive weight loss
- Remove stubborn fat deposits – especially when combined with liposuction
- Create firmer and more shapely arms
Weight loss and exercise can decrease fat in the upper arms and increase the size and tone of your arm muscles but it will not tighten or improve issues with loose and sagging skin. Once a healthy weight has been achieved and maintained through diet and exercise, surgery is the best way to remove skin and improve the shape of your arms.
An arm lift can remove excess loose skin and tissue, but it is not a replacement for weight loss. To decrease the size of the arms, either weight loss or liposuction are better options. Once you have tried weight loss and have maintained a stable and healthy weight for at least six months, you will then be in a better position to understand which Brachioplasty procedure can help you achieve your goals.
Not everyone has the body type to have the same results after contouring of the arms. The results will depend on your personal history, your body type, skin condition and the quantity of loose skin.
People want an arm lift for a range of reasons:
- Loose and sagging skin on the arms do not match their new desired appearance after weight loss
- Natural aging has left the arms with excess sagging skin or “bat wings”
- Stubborn pockets of fat remain in the arms after weight loss
- Embarrassment about the appearance of the upper arms prevents people from exposing their arms, even when it is hot
- Quality of life
People are good candidates for brachioplasty if they:
- Know why they want surgery to change the appearance of their arms
- Have an idea of what they would like to achieve with the surgery
- Are not significantly overweight
- Have stable body weight and do not anticipate future weight fluctuations
- Understand what the surgery involves
- Are non-smokers or have not smoked for six weeks or more – smoking affects wound healing
There are several possible surgical approaches that your surgeon can use for an arm lift. The technique recommended will depend on the amount of excess skin and whether you have had significant weight loss. Each technique has the potential to achieve different degrees of improvement and also leave different levels of scarring, which is an important consideration for people thinking about an arm lift procedure.
During a consultation, Dr. Xu can recommend the best technique for you after she examines your body and has a good understanding of your vision and goals.
Liposuction is not a type of brachioplasty but is a procedure to remove fat. It is appropriate for people who just wish to reduce the size and bulk of their arms, specifically targeting the fat. Liposuction alone might be suitable for people who have firm skin, good muscle tone and are close to healthy body weight.
Liposuction is also often done at the same time as skin removal during Brachioplasty in order to fine-tune the contours of the upper arm.
Liposuction does not remove the skin so if your skin is sagging, your plastic surgeon may recommend a Brachioplasty procedure.
Minimal-incision brachioplasty (also known as limited-incision brachioplasty) is suitable for people who have a small amount of excess skin located close to the armpit (axilla). In this technique, the surgeon makes a small incision in the armpit and the extra arm skin is pinched and tucked up into the incision.
The advantage of this technique is that the scar is well hidden in the armpit and will fade with time.
A standard arm lift is suitable for people with a more significant amount of extra skin and tissue on the upper arm. The incision extends along the underside of the arms from the armpit down toward the elbow. It may end above or below the elbow depending on how much skin needs to be removed and where your skin excess is located.
These techniques will leave scars that are designed to be hidden when the arms are down at the side. Scars will be more obvious when people lift their arms, but will generally fade with time.
People who have experienced massive weight loss often have sagging skin and excess tissue across the entire body, in all dimensions. To improve the appearance of their arms and the chest area they may need extended-incision brachioplasty.
In this technique, the surgeon customizes the length and direction of the incisions depending on individual anatomy. This technique can involve extended incisions into the armpit, along the lateral chest wall and/or under the breast fold to enable the surgeon to remove more skin and create a smooth, well-contoured arm and upper chest area.
This may result in significant scarring, although scars will fade with time. People having brachioplasty need to weigh the benefit of a shapelier upper arm with the level of scarring caused by the procedure.
After massive weight loss, a considerable amount of excess sagging skin on the upper arm can extend across the entire upper body. Your surgeon will need to examine your individual anatomy and design an extended-incision surgical approach to remove skin in appropriate dimensions.
Excess body weight stretches the skin considerably and people who have experienced massive weight loss are at risk for:
- Excessive sagging of skin
- Delicate and thinner skin
- Wound-healing problems
The incisions needed for extended-incision brachioplasty and the delicate condition of the skin means that people have a higher risk of complications from surgery.
People who are seeking an arm lift after massive weight loss should also ask their surgeon about the potential for staged procedures to give optimal results.
You and your surgeon must communicate and work together so you have a good understanding of the process that will give you the best results. The goal of a good surgeon should be to provide you with the knowledge to understand the factors affecting your arm lift.
Dr. Xu can discuss how your age, skin condition and the distribution of excess skin in your upper arm affect the choice of surgical technique and the results you can achieve.
It is important that you have a realistic understanding of:
- How your upper arms will look after surgery
- The limitations of the surgery
- Any short- and long-term effects such as scarring
- Any possible complications
- The potential need for staged surgery to give optimal results
Each person has a different level of scarring they can tolerate. Dr. Xu can explain which technique she would recommend for your situation and the level of scarring you can expect.
Techniques causing more scarring might also give you shapely arms that are closer to your goals. Dr. Xu can give you the information you need to weigh the benefit of a more aesthetic upper arm with the level of scarring.
Dr. Xu encourages open and honest communication about your body, your lifestyle and what you want for the future. Photos of your desired look can help her understand your needs. Your medical history is also important, including any information about pregnancies, breastfeeding, weight loss, or other medical conditions.
Things to also discuss with Dr. Xu include:
- Why you want the surgery
- Your future lifestyle goals
- What appearance you hope to achieve
- What sort of upper arm shape or form you would like
Dr. Xu understands the responsibility of transforming a person’s appearance to better reflect their identity and build self-esteem. Her top priority is understanding your vision and desires.
Once Dr. Xu has examined your body and arms, she will use her artistic sense and technical expertise to recommend an approach to your surgery that will best suit your goals.
During a consultation, Dr. Xu will explain:
- The different types of arm lift options
- Which surgical options for brachioplasty would best suit your needs
- What types of incisions will be needed
- How much scarring you can expect
- How other surgeries (eg. liposuction, tummy tuck, breast lift, mommy makeover) can fulfill your vision for your body
- Any need for further operations
- Potential complications or side effects
Once you and Dr. Xu have agreed on an approach to your surgery, Dr. Xu will book your surgery time and give you instructions on what to do before and after your surgery.
Dr. Xu will also let you know which medications you should and should not take prior to your surgery and what to do on the day of your surgery. It is important to stop smoking at least six weeks prior to surgery.
You may need to get a blood test or undergo additional tests depending on your medical history. Dr. Xu may also correspond with your primary care doctor to ensure you are in an optimal state of health prior to surgery.
In the weeks before surgery, recommendations to help you prepare include:
- Making sure you get enough sleep and rest
- Eating a healthy diet with adequate protein and nutrition
- Exercising or engaging in physical activity to strengthen your body
- Maintaining a positive state of mind
- Prioritizing your well-being and reducing stress levels
It is essential that you feel comfortable about your upcoming procedure and fully understand the process. Dr. Xu encourages her patients to ask any questions about their surgery or recovery.
After your arm lift surgery, you will feel mild to moderate discomfort. The amount of pain you feel and your overall recovery depends on a number of factors such as:
- The type of arm lift surgery used
- Whether you have had other surgeries completed at the same time (eg. thigh lift, tummy tuck)
- Your age
- Your health before the surgery
Prescription pain medications might be needed for the first few days. After this time, any pain should be relieved with over-the-counter or non-opioid medications.
For six weeks, you should wear your compression garments or wraps around the arms as instructed, and avoid lifting heavy items. Some people may have had drains inserted and should follow their surgeon’s instructions to look after the drains.
Once bruising and tenderness have gone, you can return to normal activities. Most people can return to work after a week or two, but individual ability to recover will vary. Strenuous exercise should be avoided for six weeks after surgery. Ask your surgeon when you can return to the full range of activities.
If you have had a combination of surgeries, Dr. Xu can advise you of any additional recovery needs.
Your surgeon will aim to minimize scarring, but for standard-incision and extended-incision brachioplasty, scars will be visible especially when you move or raise your arms. The level of scarring will depend on the amount of excess skin and the length of incisions needed to reshape the upper arm. Following your surgeon’s instructions will help to minimize scarring.
Scars are an important consideration for an arm lift because everyone has a different tolerance for scarring. People needing more extensive procedures should consider the benefit of an aesthetic arm shape versus the level of scarring.
Dr. Xu uses surgical techniques to decrease the risk of scars spreading or thickening. Scars never disappear, but they will fade and become less obvious with time. For some people, scars can become hardly noticeable.
It often is. Liposuction achieves fat removal only and does not address excess or sagging skin. It is not a brachioplasty per se but is often used at the same time as an arm lift to remove fat deposits and fine-tune arm contour.
Your risk of complications will depend on the specific brachioplasty technique used and Dr. Xu will make you aware of these before you have surgery. Of the body contouring procedures, brachioplasty has a higher scar burden, with scars potentially extending down to the elbow. Every person considering an arm lift should think about whether the increased risk of visible scars balances out their desire for more aesthetic arms. Brachioplasty has a higher risk for complications such as:
- Disruption of the flow of tissue fluid (lymph) and the retention of excess fluid (lymphedema)
- Scarring – depending on the amount of excess skin, scars can extend to the elbow and around the chest
- Need for staged surgical procedures – especially in cases of massive weight loss
- Additional revision surgery – may be needed to obtain the desired result, especially in cases of significant skin removal
Your risk for complications will depend on the specific technique used and Dr. Xu will make you aware of these before you have surgery. The risk of some common complications (such as scarring, infection, and bleeding) can be decreased by following your doctor’s post-surgery instructions. Potential common complications after surgery include:
- Bleeding or hematoma (a collection of blood)
- Seroma (fluid collection) requiring drainage procedures later
- Chronic pain
- Suture irritation or extrusion
- Fat necrosis
- Minor asymmetry in the appearance of the two arms
The cost of an arm lift will depend on the type of technique used and whether it is performed alone or in combination with other procedures such as breast lift, thigh lift, body contouring, or liposuction.
The combination surgeries are more complex and will cost more. The best way to understand the costs of surgery is to schedule a consultation with Dr. Xu, a board-certified plastic surgeon with a high level of technical training and the understanding of aesthetics necessary to help people achieve their cosmetic goals.
Many people are unaware of the full scope and possibilities of plastic surgery. Dr. Xu will listen to your vision for your body, review the options that are available to you, and advise you on an optimal surgical plan that will best meet your needs.