Brachioplasty (Arm Lift)

Excess skin and fat are removed from the upper arms in several ways, dependent upon on your needs and scar preference. Patients who have a significant amount of laxity will need a full arm lift, but those with moderate amounts may be suitable for less extensive surgery. Techniques include:

Liposuction alone: This shapes the upper arms and forearms in patients with fat deposits who have minimal skin laxity. However, in those patients who have excess skin, it is likely to cause increased loose skin and may result in a worsened appearance.

Limited incision arm lift: Liposuction, to shape the arms, together with short incisions (removing moderate laxity) give better contours and removes the excess skin.

The skin is excised with shortened vertical incisions in the upper third of the arms, or horizontal incisions in the axillae (armpits).

For patients with a lot of loose skin, this technique can cause distortion of the arm contour, as it only addresses the upper third of the arm. The horizontal incision scars would also be at risk of stretching, as they will then be placed under tension.


Full vertical scar arm lift: This involves tightening of the skin, from axillae to elbows, thus removing the laxity from both the front and back of the upper arms. This is combined with liposuction to remove diet resistant fat deposits. This gives the best tightening and shape improvement of the upper arms. It is performed through vertical scars, which run from the axillae to the elbows, along the inner border of the arms, where the scars are well-hidden in most positions.

Extended arm/forearm lift: Loose skin, which extends onto the chest wall and/or down the forearms, is addressed using this technique. It incorporates a full vertical scar, which is longer and can include removal of loose skin in the forearm or laxity on the side of the chest, which sits above the bra to create overhang.

The scars from arm lift procedures generally heal well and fade with time. They will, however, always be detectable in certain positions and may tend to stretch in some patients. The wounds are closed with dissolvable sutures that do not need to be removed. A waterproof glue and tape dressing is applied which means you do not need dressings and can shower immediately.

Arm lift procedures are usually carried out under general anaesthetic (you will be fully unconscious) and take between 2 to 3 hours to perform.

Providing there are no complications, you can expect to go home on the day of surgery.

The arms and hands may be swollen for a few days to several weeks following your surgery and you will experience some pain and bruising. You will be prescribed analgesia to take home after the surgery and compression garments are applied, which need to be worn for 4 weeks.

Having cosmetic surgery should be a very positive experience. Complications are infrequent and usually minor. However, all surgery is not without risk, and it is important that you are aware of possible complications. All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to discuss them. Decisions about this surgery should never be rushed.

These risks can be divided into the those specific to the surgery and those that relate to the anaesthesia.

General Anaesthetic risks: An anaesthetic is very safe, however, should a complication arise, the relevant medical expertise is immediately available to deal with this.

The risks increase if you have certain medical problems, which will be discussed at length during the consultation. The risks include:

• Unintended intraoperative awareness, which is very rare.
• Dizziness and nausea.
• Sore throat.
• Damage to teeth or mouth.
• Nerve injury due to body positioning.
• Allergic reaction or anaphylaxis.
• Malignant hyperthermia, which is a rare life-threatening condition.

The anaesthetist will go through these risks, and others, in more detail prior to your surgery.

Scars: These are hidden in most positions and run vertically down the inner arm, from the axilla to the elbow, although they can be shorter or longer depending on the degree of laxity. The scars normally settle remarkably well, so that they are barely perceptible. However, some patients can heal with noticeable thickened, thin or stretched scars.

Bruising and swelling: This is very common and may take approximately 3 weeks to resolve. Your hands will swell with gravity, so elevation of your arms helps to resolve the swelling.

Haematoma:  This can happen if a bleed occurs under the skin, allowing a large blood clot to form. If a haematoma develops, it is likely to do so within 4 to 6 hours post-surgery. Any increase in swelling or pain should be reported immediately so that treatment can be given. Sometimes patients need to have this collection of blood removed with another short operation. This does not normally delay your recovery or change the cosmetic result.

Infection:  There is a risk of infection in any surgical procedure. You are given antibiotics during the surgery and for 14 days after surgery to minimise the risks. Infections occur in less than 1% of patients and rarely require any intervention apart from antibiotic treatment.

Numbness, reduced sensation or oversensitivity: A reduction in sensation occurs in most patients and often recovers to some degree, although it may never completely recover.

Wound healing problems: These are not uncommon and normally self corrects. Healing difficulties can range from minor problems, such as small areas of wound separation, to major issues, resulting in skin loss. Although very rare, this may require a skin graft to close the wound, meaning more surgery.

Patients who have diabetes, smoke, are obese or elderly are at increased risk of delayed healing.

Asymmetry: Each limb is slightly different and will continue to be so following surgery; limbs are never identical, and it is common for one to be larger than the other. However, if you have noticeable asymmetry before your surgery then this will be corrected as part of the surgery and will be discussed with you.

Deep Vein Thrombosis/Pulmonary Embolism (DVT/PE): Following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and travel to your lungs. If the blood clot is large enough, it could prove fatal.

The overall risk for cosmetic surgery is less than 1%, but to reduce any risks of a DVT/PE, you will be provided with special stockings to wear in bed together with a blood thinning injection, if you are not mobile or have previously had a DVT or PE.

All the risks outlined above will be discussed in more detail at your consultation with me. However, if you have further questions or concerns, please do not hesitate to ask.

Decisions about cosmetic surgery should never be rushed.

The incisions are closed with dissolvable sutures that do not require removal.

I use transparent glue and tape dressings (Prineo), which are waterproof and can be peeled off approximately 2 to 3 weeks after surgery, when they start to lift at the corners.

You can shower as soon as you like after surgery and do not require any dressing changes.

I would recommend that you obtain 2 garments, as you will want one to wash and one to wear. They need to be worn day and night for 4 weeks after surgery, although you can remove them for washing.

Before you are discharged from hospital you will be given a follow up appointment to see the nurse after one week post-operatively to check your incisions. I normally see you in clinic approximately 2 weeks following your procedure.

You will not be able to drive yourself home from hospital and, ideally, you should have someone to stay with you for the first few days to assist you. If you have any concerns during this period, please contact the clinic for advice.

Scar Advice:

Once the dressings are removed, I recommend that you massage the incisions, using small circular motions at least twice a day for 5 minutes. You can use any moisturising cream of your choice and apply firm pressure until it blanches.

The scars will also benefit from silicone scar gel (ScarAway or Kelo-cote) twice a day, which will soften and fade them, as well as applying sunblock for 12 months to provide sun protection. The ScarAway can be purchased from Healthcare Pharmacy at Governors Square in Grand Cayman.

When you get home, you should take things easy for the first week or so. Most people take around 2 to 3 weeks off from work. You should be able to drive from 2 weeks, return to the gym for lower body work at 4 weeks and begin upper body exercises at around 6 weeks.

I recommend wearing compression garments to help reduce swelling as well as shaping the arms and encouraging the skin to retract naturally. You need to wear these during the day and night for 2 to 4 weeks.

This surgery is very rarely covered by health-insurers. For self-funding patients, surgical fees are a combination of the hospital costs, the surgeon and anaesthetic fees and any consumables. I do not charge an additional fee for post-op appointments. The fee is based on the surgical time rather than procedure. This means that the costs are calculated fairly, and patients with complex surgical needs may have higher costs than routine patients. You will be given a quotation for surgery within 48 hours of your consultation.

Brachioplasty Compression Garments

Brachioplasty - Nicotine and Surgery