Dr. Lindsey's Newsletter #41: The Brachioplasty. Body Contouring After Ozempic

Wings Are for Birds—Not for You: The Truth About Brachioplasty

But First, Definitions

Commonly known as an arm lift, brachioplasty is a cosmetic surgical procedure designed to remove excess skin +/- fat from the upper arms. Many medical/surgical terms are rooted in the Greek language and it is easy for me to forget that the terms are not always intuitive for my patients. I want to start teaching you how to break down the surgical terms into their root origins, that way it just makes sense for you.

The term "brachioplasty" is derived from two components:

1. "Brachio-": This prefix comes from the Greek word "brachion," meaning "arm."
2. "-plasty": This suffix is rooted in the Greek word "plastos," meaning "formed" or "molded."

Together, "brachioplasty" essentially translates to the "molding or forming of the arm."

Now that you understand the definition, let’s talk about how we define those arms.

Wings Are for Birds—Not for You: The Truth About Brachioplasty

But First, Definitions

Commonly known as an arm lift, brachioplasty is a cosmetic surgical procedure designed to remove excess skin +/- fat from the upper arms. Many medical/surgical terms are rooted in the Greek language and it is easy for me to forget that the terms are not always intuitive for my patients. I want to start teaching you how to break down the surgical terms into their root origins, that way it just makes sense for you.

The term "brachioplasty" is derived from two components:

1. "Brachio-": This prefix comes from the Greek word "brachion," meaning "arm."
2. "-plasty": This suffix is rooted in the Greek word "plastos," meaning "formed" or "molded."

Together, "brachioplasty" essentially translates to the "molding or forming of the arm."

Now that you understand the definition, let’s talk about how we define those arms.

Weight Gain and Loss in The Arm

With weight gain fat accumulates throughout the body and there is significant collateral damage with that weight gain. As fat cells grow in your arms the skin envelope is stretched, thinned, and often stretch marks are formed. Small fluctuations in weight are often managed by the skin decently well and there can be good elastic recoil after weight loss - meaning no sagging skin. With increasing weight gain there comes a point that the skin is pushed beyond it’s limits and the Spanx of the skin is broken. Once elasticity and integrity of the skin is lost the body loses it’s ability to shrink the skin to the arm after weight loss. Significant weight loss in the arms will result in a smaller arm and sagging skin. There is no body tightening procedure or magical laser device that can fix sagging skin. The only procedure that can produce a noticeable change and a good outcome is surgery.

Weight Gain and Loss in The Arm

With weight gain fat accumulates throughout the body and there is significant collateral damage with that weight gain. As fat cells grow in your arms the skin envelope is stretched, thinned, and often stretch marks are formed. Small fluctuations in weight are often managed by the skin decently well and there can be good elastic recoil after weight loss - meaning no sagging skin. With increasing weight gain there comes a point that the skin is pushed beyond it’s limits and the Spanx of the skin is broken. Once elasticity and integrity of the skin is lost the body loses it’s ability to shrink the skin to the arm after weight loss. Significant weight loss in the arms will result in a smaller arm and sagging skin. There is no body tightening procedure or magical laser device that can fix sagging skin. The only procedure that can produce a noticeable change and a good outcome is surgery.

Brachioplasty Surgery

The goal of a brachioplasty is to remove excess skin +/- fat and restore a skin envelope that fits the size of the upper arms. There are certain features of the arm that I assess when I am creating a tailored surgical plan for each patient, and these include:

• Assess for excess fat
• Assess excess skin
• Identify location/particular areas of excess
• Assess overall skin quality and tone

Once I assess each of these components I am able to create a plan that will include some combination of skin excision, liposuction, and a carefully planned scar. There are some cases that I evaluate the patient and determine that they are not a candidate for the surgery.

Brachioplasty Surgery

The goal of a brachioplasty is to remove excess skin +/- fat and restore a skin envelope that fits the size of the upper arms. There are certain features of the arm that I assess when I am creating a tailored surgical plan for each patient, and these include:

• Assess for excess fat
• Assess excess skin
• Identify location/particular areas of excess
• Assess overall skin quality and tone

Once I assess each of these components I am able to create a plan that will include some combination of skin excision, liposuction, and a carefully planned scar. There are some cases that I evaluate the patient and determine that they are not a candidate for the surgery.

Scar Placement and Length

The length and position of the scar will depend upon your anatomy and the surgical technique preferred by your surgeon. I place the scar on the inner arm because I think it is less noticeable. Other surgeons place the scar on the back of the arm, out of the patient’s sight but easily noticed by anyone behind you. The two main surgical options that I offer my patients include:

1. Traditional Brachioplasty Scar:

• Location: This scar extends from the armpit (axilla) down to the elbow, following the inner side of the upper arm.
• Description: It is a longer, more visible scar but allows for the removal of a significant amount of excess skin and fat, providing dramatic reshaping of the upper arm.
• Indication: I offer this procedure to patients who have loose skin the entire length of their upper arm.

2.  Mini or Limited Incision Brachioplasty Scar:

• Location: This scar is shorter and usually confined to the armpit area and upper arm.
• Description: It is less noticeable and smaller, but it removes a limited amount of skin and fat. This option offers a more discreet scar but less extensive contouring compared to the traditional approach.
• Indication: I offer this procedure to patients with sagging skin localized to the upper part of the arm near the armpit.

Who is a Good Candidate?

Safety is first and we look for the following attributes in potential patients:

• In good overall health
• Must not have medical conditions that could impair healing
• Weight stable
• Non-smokers
• No nutritional deficiencies

Massive weight loss is often accompanied by malnutrition because of changes in absorption and restricted eating. Because of this I require my massive weight loss patients to have labs done. All nutrition deficiencies must be corrected prior to surgery and protein supplementation is required. Even with these precautions it is not uncommon for the incision to have some difficulty healing. Without these precautions disastrous wound healing complications can occur. My goal is to keep you as safe as possible and to set you up for healing success.

Scar Placement and Length

The length and position of the scar will depend upon your anatomy and the surgical technique preferred by your surgeon. I place the scar on the inner arm because I think it is less noticeable. Other surgeons place the scar on the back of the arm, out of the patient’s sight but easily noticed by anyone behind you. The two main surgical options that I offer my patients include:

1. Traditional Brachioplasty Scar:

• Location: This scar extends from the armpit (axilla) down to the elbow, following the inner side of the upper arm.
• Description: It is a longer, more visible scar but allows for the removal of a significant amount of excess skin and fat, providing dramatic reshaping of the upper arm.
• Indication: I offer this procedure to patients who have loose skin the entire length of their upper arm.

2.  Mini or Limited Incision Brachioplasty Scar:

• Location: This scar is shorter and usually confined to the armpit area and upper arm.
• Description: It is less noticeable and smaller, but it removes a limited amount of skin and fat. This option offers a more discreet scar but less extensive contouring compared to the traditional approach.
• Indication: I offer this procedure to patients with sagging skin localized to the upper part of the arm near the armpit.

Who is a Good Candidate?

Safety is first and we look for the following attributes in potential patients:

• In good overall health
• Must not have medical conditions that could impair healing
• Weight stable
• Non-smokers
• No nutritional deficiencies

Massive weight loss is often accompanied by malnutrition because of changes in absorption and restricted eating. Because of this I require my massive weight loss patients to have labs done. All nutrition deficiencies must be corrected prior to surgery and protein supplementation is required. Even with these precautions it is not uncommon for the incision to have some difficulty healing. Without these precautions disastrous wound healing complications can occur. My goal is to keep you as safe as possible and to set you up for healing success.

Sag or Scar? When Do I Choose a Brachioplasty?

If you have to carefully choose your clothing to accommodate for loose skin on your arms then your quality of life would likely benefit from brachioplasty surgery. The less saggy skin you have, the returns become diminishing because of the scar. Even so, we have very happy patients who had small amounts of skin removed and were pleased to trade the sag for a scar. Ultimately this decision is about your own personal aesthetic goals. If you are wondering if this surgery is right for you then I invite you to schedule a private consultation where I will provide an expert evaluation with educational feedback.

As always, here's to choosing how we age, on our own terms!

Sag or Scar? When Do I Choose a Brachioplasty?

If you have to carefully choose your clothing to accommodate for loose skin on your arms then your quality of life would likely benefit from brachioplasty surgery. The less saggy skin you have, the returns become diminishing because of the scar. Even so, we have very happy patients who had small amounts of skin removed and were pleased to trade the sag for a scar. Ultimately this decision is about your own personal aesthetic goals. If you are wondering if this surgery is right for you then I invite you to schedule a private consultation where I will provide an expert evaluation with educational feedback.

As always, here's to choosing how we age, on our own terms!