What is the brachioplasty procedure
Sagging arms are a problem that we encounter very often, especially in postmenopausal women or in people who have lost a lot of weight and causes both aesthetic and functional issues. Arm lift known as brachioplasty is the operation with which we surgically treat the problem of sagging, removing part of the excess skin. The disadvantage of these operations is unfortunately the scars and for this reason we need to set the right indication of the operation only when there is no other way to improve the problem.
We will separate the cases of problems we see in the arm area, so that it is better understood how we choose each technique.
Brachioplasty with liposuction
The first case is arm adipositas, where due to extra pounds, due to anatomical predesposition or lipoedema, it excessively increases the weight of soft tissues and gives the image of relaxation when the arm is stretched. If the quality of the skin is good, the purpose of the correction is to relieve the arm of excess weight and this is usually achieved by liposuction. The great advantage of liposuction is that it does not leave any scars and the result is very satisfying and even excellent. It should be noted that I often encounter a number of patients that are very sceptical when proposing liposuction as means to treat arm laxity, who fear that if we remove the fat the skin will relax. From my experience I can say with certainty that if a proper skin assessment is made, the result of liposuction on the arms is spectacular and we avoid larger operations such as brachioplasty, which leave strong marks for many months.
The next type is mild relaxation, located mainly in the upper third of the arm towards the armpit. In these cases, we may also encounter hyperliposis. The treatment can be done with mini brachioplasty, which is a small intervention with a much smaller incision made in the armpit and remains mostly hidden. This method can be combined with liposuction when necessary.
When there is intense relaxation in the arms, the usual treatment is done with horizontal brachioplasty, where all excess skin is removed along the arm from the elbow to the armpit. When there is intense hyperliposis, it can be combined with liposuction during surgery. The design of the operation is such that scars are as little visible as possible and ideally covered when the arms are close to the body.
In very intense relaxation, which we encounter mainly after great weight loss, the problem may extend under the armpits, back and chest. Brachioplasty with the horizontal incision in these cases needs to be modified to include a greater area of relaxation, either below the elbow or under the armpit and towards the back.
As shown above, depending on the degree of relaxation we choose the appropriate technique. When it comes to fat accumulation with good skin elasticity, careful and targeted liposuction is performed. The skin usually needs 3-4 months to shrink and reduce its sagging. The key to success is the right choice of people for whom liposuction is suitable as well as the excellent liposuction technique, otherwise it can make the problem of relaxation worse.
In a small to moderate degree of relaxation, correction can be made with a small incision at the border of the armpit, without an additional longitudinal incision. The advantage of mini brachioplasty is that we can thus avoid the large incisions of classical brachioplasty and hide them near the armpit, where they are less obvious. This technique is combined with liposuction, which will give an aesthetically superior result. This procedure can also be performed under local anaesthesia and recovery is relatively simpler.
In a high degree of relaxation, which extends to the elbow, longitudinal incisions on the inner surface of the arm are necessary. In even greater relaxation that extends below the height of the armpit it is also necessary to extend the incisions downwards, combining a plastic Z, in order to maintain the functionality of the arm. The length of the incision depends on the extent of loosening and is decided by design.
Recovery after brachioplasty
Classic brachioplasty is performed under total anaesthesia and does not require hospitalization in the clinic. The same applies to mini brachioplasty and liposuction on the arms. After surgery, place a bolero until below the elbow for 3 weeks. This helps us reduce swelling and have an even better aesthetic result. There is no particular pain after brachioplasty and no specialized painkillers are needed.
For the first period, arm movements need to be a little restricted, avoiding excessive extension and abduction and generally intense physical activity. Gymnastics, sports and swimming can begin after 1 and a half months.
The scar, after taking its final form after 8-10 months, becomes quite good and is placed in such a position that it is not perceived when the arm is raised up to the horizontal plane. In cases where mini plastic surgery is performed, scars are hidden from the beginning in the armpit and are barely visible.