Arm tissue relaxes and descends with aging, gravity, and weight loss. The drooping of skin is from a stretching of the anchoring fascial system and loss of supporting fat. The extra sagging can result in significant “loose hammock” like deformity from the axilla to the elbow. Some call this a “bat wing” deformity.
There are different degrees of ptosis (drooping) deformity. Brachioplasty arm reduction surgery can remove the excess tissue and reduce the circumference of the upper arm. Surgical correction depends on the amount of extra skin and how loose the supporting tissues have become. Extra skin is removed from incisions along the inner arm. The incision must be placed where the tissue can be best tightened.
The most common incision extends from the elbow to the axilla. This permits the excision to maximally address the redundant skin in the middle. Modification of the incision may be necessary to limit scar contracture in the axilla.
Surgical sculpture involves not just the superficial skin, but also the deeper attachments that have loosened.
In cases of limited extra skin, the incision can be hidden in the axilla. This can re-suspend tissues in some cases but is not a very good answer for extensive redundant skin.
Because of the level of the incisions, visible scars can be a major concern. It becomes a choice between the loose wobbling extra skin and the scar from the excision. Meticulous surgical technique, after surgery scar care can limit the degree of scarring. Clothing style can help camouflage some of the scar, but not the loose skin before surgery. Other possible complications include persistent swelling of the arm, infection, bruising, and bleeding. Nerve injury can result in numbness and change in feeling.
This surgery is not suitable after mastectomy or operations in the axilla lymph nodes. Those with multiple infections of the sweat gland may also not be candidates for brachioplasty. Drainage of the arm may already be impaired, and further surgery may lead to permanent arm swelling.
This operation is usually done as an outpatient under general anesthesia or local with sedation. The choice depends on the extent of the operation, but most are more comfortable having this done asleep.
After Surgery Care
Recovery takes one to two weeks, depending on what was done. Return to work depend on the activity needed on the job but is often about 2 weeks. The dressing may be extensive with elastic support or something smaller. You will need to protect the incisions after surgery. Limiting lifting is important. Elevation with pillows increases comfort. It can take 6 months or more to see how the scars will evolve.