The arm lift (brachioplasty) firms and reduces the diameter of the arm, removes excess fat and tightens and corrects excess, sagging skin. It is now a frequently performed operation in cosmetic surgery and ensures that the arms look more defined, toned and aesthetically pleasing. This procedure is also called a brachioplasty or an arm dermolipectomy.
The arm can present two main anomalies: a problem of volume, where the arm is too broad or too large, or an abnormality of the skin, where there is an excess of sagging skin (either due to a significant loss of weight or because of age, sun, skin quality, menopause etc.). We therefore act on these two factors, volume and or skin.
A description of the arm lift or brachioplasty
The excess fat in the arm is removed by gentle liposuction. In some cases, liposuction alone may be enough when there is no excess skin and the skin itself it is of very good quality. In this case, only two, almost invisible, micro-incisions are made. In most cases, however, liposuction of the arms alone is not sufficient and excess skin has to be removed.
In these cases a resulting scar is unavoidable. It can be axillary only, that is to say located in the armpit and, therefore, very discreet. This axillary or transaxillary arm lift technique is possible if the amount of excess skin is small. If the amount is significant then the scar will be located on the inside of the arm, running from the armpit to the crease of the elbow. It is generally very fine.
There are therefore three different arm lifting techniques:
- liposuction of the arms (no excess skin)
- liposuction of the arms with horizontal axillary arm lift scar (moderate excess of skin)
- liposuction of the arms with internal longitudinal arm lift scar (significant excess of skin)
If there is simply excess fat and the skin quality is excellent then we will just remove the fat by liposuction. Two small incisions of a few mm are enough to introduce the liposuction cannulas. If the skin is of too poor a quality, and once the fat is removed there is going to be an excess of skin, then there is no choice but to remove it. An incision in the armpit is made and allows the skin to be tightened in a distal proximal direction, i.e. from the elbow to the shoulder. The problem is that the scar may migrate out of the axillary cavity or widen if too much skin is removed and the effect is almost zero beyond the distal half of the arm. We then have to make a longitudinal scar in addition to the inner portion of the arm which can go down to the elbow, a bit like the seam on the sleeves of a shirt. It is the best technique to achieve a concentric morphological effect on the arm. But there has to be a scar, which is fortunately discreet in most cases after a few months of evolution. Finally, in some cases where there is just a sagging of the skin but without any excess fat, we will only remove the skin, either with a scar in the armpit or an additional longitudinal scar.
Frequently asked questions concerning an arm lift procedure
What happens before the operation?
Two consultations with your cosmetic surgeon, Doctor Vincent Masson, are compulsory. An information sheet and a quote indicating the price of the arm lift will be given to you. A minimum period of 15 days is mandatory between the first consultation and the operation itself (the legal reflection period). You will be prescribed a pre-operative check-up (blood test) as well as specific compression garments (sleeves). The taking of medical photographs is systematic. A consultation with the anesthesiologist takes place at the latest 48 hours before the operation. Do not take aspirin, anti-inflammatory drugs or anticoagulants 10 days before the brachioplasty and it is very important to stop smoking before the operation as well (smoking increases the risk of complications and poor healing).
What type of anesthesia is used for an arm lift?
The anesthesia is general. Sometimes, local anesthesia associated with sedation (a relaxing drug) is possible.
How long is the operation?
Depending on the type of arm lift that is indicated for you, it lasts between one and two hours.
How long is the hospital stay?
A 24-hour hospitalization (one night stay) is the general rule (entering the hospital or clinic in the morning and leaving the next morning). Generally, the stay is fairly quick, a maximum of a day or a night. It is not a very painful operation, but having the arms operated on is troublesome in everyday life at the beginning because the arms are constantly primed to perform routine, normal gestures.
Is it painful?
A brachioplasty is not a very painful procedure and pain medication is routinely prescribed after the operation. The post-operative pains (tightness, aches) subside in 3 to 8 days. In fact, more than any real pain, there is a sensation of hindrance during the activities of daily life as moving and, in particular, raising the arms is difficult for the first few days (it is more of an apprehension of movement than anything else). This sensation of discomfort can persist for up to 10 days.
Is a drain necessary?
The old arm lift techniques required the setting up of a drainage system (redon drain), which was uncomfortable for the patient. Doctor Vincent Masson was fully trained in modern plastic surgery techniques and does not need to install a drain for this operation in the vast majority of cases.
What are the postoperative effects?
The first dressing that was made in the operating room is removed the day after the operation. The arm is swollen and often bruised but the bruises fade in 7 to 15 days. Showering is possible the day after the operation. A simple bandage is applied to the scar after the shower and the compression sleeve then worn day and night for 6 weeks. It is simply removed while taking a shower and re-dressing. The dressing is to be redone every day for 3 to 10 days. The compression sleeve is essential to help the skin recover and reduce swelling. The sutures are absorbable, so there are no threads to remove. The post-operative care and recovery procedures are therefore relatively simple.
The scar is red for the first 3 months and tends to be itchy. It then fades and its final appearance is obtained after 1 year. A healing cream will be prescribed to you by your cosmetic surgeon. The scar should be protected from the sun for the first year (use sunscreen). The sensitivity of the arm is modified and decreased for the first 3 months, without being too disruptive.
Five to ten days off work of is recommended and sport can be resumed after 6 weeks (4 weeks for non-violent sports).
When will the results be visible?
Swelling persists for 6 weeks after the operation, regardless of the operating technique or the surgeon. Hence the importance of wearing the compression sleeves. The swelling will gradually subside and the morphological results will be visible after 3 months. The improvement is often spectacular, the diameter of the arm is reduced, the skin is tight and no longer sags (ptosis correction). The scar is final after 1 year.
Can the surgery be covered by social security?
In some cases (significant weight loss after bariatric gastric surgery such as gastric sleeve, gastric band, bypass and major skin excess of the arms), part of the operation may be covered by social security after prior agreement with a health insurance doctor.
What are the potential complications?
In order to minimize the risk of post-operative complications, two important things have to be done: it is important to stop smoking before the operation (tobacco increases the risk of defective scars, infections and hematomas) and to have a weight close to normal (being overweight increases the risk of infections, hematomas and unsightly scars).
The main complications are rare and are as follows:
- Prolonged swelling (which may go down to the hand). It always resolves itself spontaneously.
- Localized infections (favored by being overweight and smoking). Evolution favorable under treatment.
- Hematoma sometimes requiring re-operation
- Lymphatic effusion (seroma), self-resolving
- Prolonged disturbances of sensitivity, self-resolving
- Skin necrosis
- Asymmetry requiring a little retouching
- Defective scar (hypertrophic, dyschromic, retracted).
If you have the slightest concern after the operation, do not hesitate to contact your cosmetic surgeon, Doctor Vincent Masson or his assistant.
What is the price of an arm lift?
There are two different cases, if the problem is related to a massive weight loss after stomach surgery with a gastric bypass or sleeve a prior agreement request will be made to the social security system under the code QZFA014. If the request is agreed, part of the operation will be reimbursed by the social security system and a possible mutual complementary health insurance, but not entirely. If there is no agreement or the request is strictly aesthetic then there is no reimbursement possible and all the costs are the responsibility of the patient. The cost is at least 4000 euros.
Summary sheet of the arm lift procedure
Before the operation:
- Two consultations with your surgeon, Doctor Vincent Masson
- Pre-operative assessment (blood test)
- Taking medical photographs
- Purchase of compression garments (sleeves)
- Meeting with the anesthesiologist at least 48 hours before the surgery
- Submission of a price estimate and sometimes prior agreement for partial coverage iby the social security system
- Weight normalization and cessation of smoking and taking aspirin or anti-inflammatory drugs
- 24h hospitalization, general anesthesia (sometimes local with sedation)
- Duration 1h to 2h
- Axillary or longitudinal technique for the arm lift scar according to excess skin and associated liposuction
After the operation
- Bruising for 7 to 15 days
- Swelling for 6 weeks, essential to wear compression sleeves day and night for 6 weeks
- Shower every day and simple dressing for 3 to 10 days
- No sutures to remove (absorbable)
- Moderate pain for a few days (aches) and discomfort in raising the arms for a week
- Final result: 3 months for the shape and 1 year for the scar (protect from the sun for 1 year with sunscreen)
- Resumption of sport and swimming after 6 weeks (4 weeks for non-contact sports)
- 5 to 10 days off work