Brachioplasty
I have touched on Brachioplasty in the massive weight loss section of this webpage but it is popular enough and sometimes misunderstood enough to warrant its on section on my site.
Liposuction or Brachioplasty?
The paradox of brachioplasty is that many people want the skin tightening it provides, but not the scar. Once again the key is elasticity of the skin. If the arms are full and not droopy liposuction alone of any kind will give a nice result. If the skin is loose liposuction will remove fat, but the loose skin will remain. Brachioplasty removes both the extra skin and fat.
Before
After
The Brachioplasty scar:
Brachioplasty is notorious for making thick or wider scars. It is an operation that, centered under the arm is subject to constant motion as the skin heals. I call this a push me/pull me operation. The scar when closed is subject to these forces and because scar tissue is living and dynamic it responds to these stresses. I have had patients make beautiful scars with brachioplasty and like any surgeon I have seen some widen. The key for the patient is to understand these possibilities and be accepting of them good or bad.Types of Brachioplasty:
Examples or the types of brachioplasty I perform are shown below. How I guide my patients depends on how loose they are. Brachioplasty can be as short as a scar under the armpit or can extend from the forearm to the chest wall. It depends on the degree of laxity.Types of brachioplasty
Brachioplasty
A fill brachioplasty tightens the skin along the axis of the arm and pulls it up under the armpit as well the scars stop at the armpit.
Before
After
A fill brachioplasty tightens the skin along the axis of the arm and pulls it up under the armpit as well the scars stop at the armpit.
Extended
An extended Brachioplasty extends under the armpit along the side of the chest. Many patients have extra skin her after significant weight loss.
Short scar Brachioplasty:
Short scar Brachioplasty takes a wedge of skin out under the arms. It gives a limited amount of vertical pull and a subtle result. It is really best for patients with a skin bulge under the armpit.
Brachioplasty or Arm liposuction ?
This question is probably one of the most confusing to my patients who come in striving for information on what I call “the very dangerous Internet”. Over the past few years liposuction has been hyped and hyped and hyped to the extent that it is being performed in many cases where it should not. So, some basic concepts that I hope will help you.- Liposuction removes fat, but not skin. Most patients come in grabbing a roll they want removed thinking only about the fat. Rolls are a fat skin combo.
- Removal of volume, fat, makes us looser not tighter.
- Liposuction of any sort (even laser or ultrasound) does a poor job of tightening the skin.
The best candidates for liposuction are the ones with good skin elasticity. Paradoxically our younger patients, the ones who should need liposuction the least, do the best.
So, hold your arms out at your side. Wiggle them front to back. If there is a hanging bunch of skin and fat that swings in the breeze you will likely need to remove fat, but also tighten the fabric or skin of your arm. If the fat stays firm with you , you may be a candidate for arm liposuction.
When in doubt rest assured I will always be happy to guide you.
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