Arms are increasingly an area that women, in particular, worry about over time. The appearance of loose skin on the upper arm is seen as a stigma of ageing especially as it becomes more pendulous (bingo wings).
The difficulty with loose upper arm skin is that virtually the only treatment involves surgery. Women will very diligently go to the gym to try and tone their upper arms through exercise and weight lifting but invariably this makes little difference.
Once loose skin is present the only way to treat it is through surgical removal. Occasionally in those with heavier arms liposuction can help if the skin tone and quality is good.
Where skin needs to be removed, however, a certain amount of scaring will be necessary in exchange for an improved upper arm contour.
The surgery is normally carried out under a general anaesthetic either as a day case or as an overnight stay. The type of surgery required will depend on the extent of the problem.
Types of arm lift
The type and design of the arm lift will depend on the nature of the problem. In general, the more loose skin there is to remove, the more extensive the scarring will be in order to produce an optimal result.
This is indicated in those with heavy arms (not necessarily loose skin), in whom the skin quality is good, and there is not very much skin excess. The liposuction works by removing the excess fat from the arm thereby reducing the circumference and producing a thinner upper arm. Very small scars (3-4mm) are used to access the upper arm fat using thin liposuction cannulae.
Bruising can last for 10 -14 days, and swelling can last for up to 6 weeks. The outcome is likely to improve further over 3-6 months. Patients are usually asked to wear an elasticated garment for a period of time to help with the swelling and aid recovery. Recovery is quick with very little time off work required and full activity can be resumed when the bruising resolves.
Limited arm lift (armpit scar)
The limited arm lift is indicated in those who have a modest amount of loose skin in the upper arm which does not extend towards the elbow.
In such cases skin is removed as an ellipse into the armpit leaving a well hidden scar which is only visible with the arms raised. It is often combined with liposuction so that both volume and skin can be removed to produce an optimal outcome.
The wound in the armpit usually takes about 2 weeks to heal and is sometimes accompanied by mild bruising during this period. It is common for the wound to feel tight during the healing process as the armpit is extremely mobile during activity.
Patients are warned about minor infections and healing delays in this area as well as thickened scarring which may take time to resolve.
Recovery is generally fairly quick with return to activity after the wounds have healed, however, full recovery may take 4-6 weeks to allow the wounds to strengthen fully. Patients are advised on scar care in order to maximise the healing process over time.
Full arm lift
This is the most extensive of the techniques and is indicated in those who have a large amount of loose skin throughout the upper arm often extending towards the elbow. In such cases liposuction or limited scar techniques will not be sufficient to deal with the skin excess.
Surgery involves removing skin from the armpit towards the elbow keeping the incision line on the inside of the arm in order to keep it as discreet as possible. Liposuction can also be used at the same time to reduce any excess fat.
Patients must be aware of the scarring in this procedure and that it is essential in order to produce an improved upper arm profile in those with significant amounts of baggy skin.
Dressings and garments are used in the initial stages for comfort and to assist with recovery. It takes approximately 2 weeks for the wounds to heal. Patients are advised to moderate their activity during this period until the wounds have healed. 1 week off work is advised or a little longer for those who have more physical jobs.
Return to full activity is between 4 and 6 weeks depending on recovery. Patients are warned that minor wound complications are not uncommon and are easily dealt with by simple measures. There may be areas of numbness in the upper arm which can persist for some time.
The scar can also take a while to settle as it is subject to the stresses and strains of everyday arm movement. It may take 6 – 12 months before the scars to remodel fully becoming softer, thinner and blending in more with the surrounding skin.
If you are concerned about the appearance of your upper arms your surgeon will happily advise you on the most suitable intervention for you, explaining the advantages and disadvantages of each technique. As with all areas of cosmetic surgery, realistic expectations and a thorough understanding of the process are essential for a good outcome.
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