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Arm Lift (Brachioplasty)

INTRODUCTION

Extra skin and fat in the upper arms can cause a person significant grief. When someone loses weight, inherits bad genes, or simply ages, the upper arm skin can sag, leaving the arms to have a batwing-like appearance. Exercise may tighten the muscles and reduce the fat, but it will not improve sagging skin that has lost elasticity. The best solution is an arm lift.

The arm lift operation has gained a lot of popularity in recent years due to weight loss surgeries and a large population of people who are left unhappy with the droopy appearance of the underside of their upper arms. An arm lift surgery is a straightforward operation with very high satisfaction among patients because it enables them to have a more toned upper arm appearance, more self-confidence, and more fashion choices. The scar on the inner aspect of the arm, extending from the underarm to the elbow, is usually well tolerated given the benefits of this procedure. This procedure is often combined with other upper body procedures in the significant weight loss patients.

PREPARING FOR SURGERY

An initial consultation is set-up where we discuss the arm lift procedure, and whether you are a good candidate for the surgery. Your medical history is reviewed, and you will be asked to see your medical doctor for a physical check-up and a few labs to make sure you can undergo the surgery safely. You are given the opportunity to be seen by your own doctor to give the green light for surgery. You are asked to stop medications that cause bleeding, such as aspirin, or aspirin-like products (Motrin or Ibuprofen), a week before this procedure. You are asked to stop smoking two weeks before and two weeks after surgery, for the surgery to be performed safely, and for you to have optimal results. You are given the opportunity to talk to patients who have had the same surgery you are considering. We will see you shortly after the surgery (usually in a day or two). You are seen regularly after your surgery. You are always welcome to come back for follow-up, even years after your surgery, free of charge.

PROCEDURE DESCRIPTION

The appropriate candidate for the arm lift procedure is a patient who has loose skin, or loose skin and excess fat of the upper arm. It is important to note that if a patient has good muscle tone, good skin tone, and excess fat of the upper arm, then they may be a better candidate for liposuction of the upper arm. In some patients with significant weight loss, there is excess skin as well as residual excess fat of the upper arm. In this situation, an arm lift can be combined with adjunctive liposuction to contour the arm.

The arm lift procedure is about one to three hours long. It involves making a Y-shaped or S-shaped incision placed in the upper arm extending from the arm pit to the elbow, depending on the amount and location of the sagging skin. The excess skin and fat are removed to create a more aesthetically pleasing, and firmer, upper arm with a Y-shaped or S-shaped scar.

HOW WE MINIMIZE COMPLICATIONS OF ARM LIFTS

At the Bitar Cosmetic Surgery Institute, we take pride in making sure we provide for our patients the best surgical experience possible, anticipating problems or set-backs, and addressing them before they happen. This is a process that includes the pre-operative preparation, the actual surgery, and the after care.

General Complications
General complications can occur with any surgery. Cosmetic surgery is usually a safe surgery performed on healthy patients and, as all surgeries go, is with low risk. What we do to even lower the risk of complications is to operate at a first class surgery center with board certified anesthesiologists and nurses. To avoid post-operative complications, we advocate early mobilization –patients seen in our office one or two days after surgery- and active participation in their own post-operative care. When we create a partnership, the results invariably improve.

Bleeding
Bleeding after an arm lift is rare. Before surgery, our patients are tested to make sure they don’t have any common bleeding disorders by their own physicians, and by lab tests. In our practice the rate of significant bleeding is less than 1%. The treatment of a hematoma or a blood clot under the skin of the arm is to open the incision and remove the blood clot. Typically, this is a straightforward procedure.

Infection/Wounds
The most important step in avoiding infections/wounds, in our opinion, is to perform the surgery at a first-rate surgical facility with board certified anesthesiologists and nurses. Patients are given the appropriate intravenous antibiotics coverage throughout the surgery. During the surgery, the skin surface of the patient is cleaned properly. After the procedure, my patients are prescribed antibiotics to minimize infection. As a result of these extra precautions, my rate of infection after an arm lift is extremely rare. Conservative removal of skin is important for the results to be good, but also so that the skin is not under too much tension after the arm lift. Wound healing problems may occur at the superficial incision level where the tension is highest, and a small open wound may occur which will usually heal nicely with dressing changes and antibiotic ointment.

Nerve Injury
There are important nerves that pass from the neck, down the arm, and to the hand. In performing an arm lift, it is important to avoid injuring these nerves. The way to minimize nerve injury is to resect a conservative amount of skin, thus creating minimal tension in the upper arm, but yet achieving an aesthetically pleasing result. Occasionally, nerves can get stunned or bruised, and function may take a few days to weeks to return. Our rate of permanent nerve injury in arm lifts has been minimal.

Seroma, Lymphocele, Lymphedema
There are important lymph nodes and vessels around the elbow and in the arm. In performing an arm lift, it is important to preserve as many of these lymphatic channels as possible. This will reduce the chances of a lymph collection or prolonged swelling. If you have a history of a mastectomy or radiation to the area, you should discuss this further with your surgeon.

Smoking
Smoking is an absolute contraindication for an arm lift. The carbon monoxide and nicotine in cigarette smoke causes severe reduction in blood supply to the skin and breast tissue during healing. This results in delayed wound healing, wound separation, death of the skin, and a higher risk of infection. Cotinine testing is performed in patients with a smoking history to ensure that they are safe when having this procedure.

RECOVERY

Our office will provide a comprehensive post-operative plan to ensure the best possible outcome. The plan will include what to expect postoperatively, such as estimated recovery time, pain management, garments or dressings, and anticipated activity level. For your safety, we require that an adult stay with you at least the first 24 hours after surgery and drives you to your next day follow-up visit. With most procedures, you will be instructed to limit activity for the first week or two, which could include restrictions on driving, prolonged travel and flying. In addition, we ask you refrain from exercise until cleared by the physician, usually around four weeks post-op. You are asked to refrain from smoking for a minimum of two weeks. To optimize healing, we recommend that you eat a high protein diet. You should anticipate a variable degree of bruising and swelling, as with any surgical procedure; light make-up may be used to cover bruises starting a week after surgery. We also offer scar creams at an additional cost to optimize results.

To promote healing and minimize complications, you will be seen in a series of post-op appointments, including the day after surgery. These appointments will continue throughout the first year after the procedure to make sure you are healing as planned. For your added convenience, you also have direct access to Dr. Bitar’s cell phone number if you need to reach him after hours. The final post-op visit, one year after surgery, is one of our favorites since the results are fully apparent and we love seeing our patients happy. You are always welcome to come back and see us, even years after your surgery.

MAXIMIZING POSITIVE OUTCOMES

At the Bitar Cosmetic Surgery Institute, we take pride in providing our patients with the best surgical experience possible, emphasizing patient safety while trying to optimize surgical results. This is a process that includes comprehensive pre-operative preparation and patient education, the development of a personalized operative plan, and a thoughtful post operative care regimen emphasizing patient comfort and promoting recovery.

There are a number of strategies which the Institute has adapted to further ensure patient safety. We are selective and only offer surgery to patients whose general health and lifestyle choices permit healing and facilitate recovery. To minimize risk, we require a preoperative assessment that includes a thoughtful history and physical exam, as well as targeted laboratory tests.

We operate at accredited hospitals and surgicenters that have demonstrated a commitment to the highest standards of care, employing board certified anesthesiologists and nurses. We adhere to well established surgical principles designed to ensure patient safety and have developed policies and protocols to minimize the risk of infection. Dr. Bitar is committed to continuing education, honing his skills and introducing new techniques always with the aim of improving safety and surgical results.

We emphasize patient safety in our peri-operative care plan, advocating early mobilization, optimizing nutrition, and providing detailed care instructions. After surgery, patients are seen in our office frequently and early, starting the day after their procedure, and a staff member is available around the clock for any questions or concerns. Our entire team is committed to our patients’ well being and every measure is designed to minimize potential complications, promote comfortable and rapid recovery, and optimize surgical results.

WHY CHOOSE BITAR COSMETIC SURGERY INSTITUTE?

Our commitment to excellence and exceptional patient care is in every step of your doctor-patient experience. Dr. George Bitar, board-certified plastic surgeon stays on the cutting edge of advancements in cosmetic surgery and technology to offer the best possible results. With a blend of artistry and meticulous surgical technique, he is able to achieve beautiful and natural results for our patients. We provide a high level of patient safety and our experienced and caring staff will be with you every step of the way. Our institute offers a wide variety of surgical and non-surgical options, from skin care, injectables and lasers to in-office or hospital options, to provide a versatile approach to fit individual patient needs. Your aesthetic goals are our priority and each procedure is customized to ensure you receive the best possible outcome.

For more information, call our office at 703-206-0506.

Content on this website is for information only and should not be used to diagnose or treat your plastic surgery or cosmetic surgery problems. Please contact your plastic surgeon with all questions and concerns.

CONTACT OUR OFFICE FOR A CONSULTATION

If you would like further information regarding this procedure, please feel free to contact our Fairfax, VA office to schedule an appointment by calling (703) 206-0506 or filling out an online request form.