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Brachioplasty, or arm lift, is a surgical procedure that reduces flabby, loose skin in the upper inner arm. In 2004, the total number of these procedures climbed 53 percent from 2003 to about 17,000. Loose upper arm skin is usually related to weight loss. Skin is stretched with weight gain; when the pounds come off the skin sags. In addition, skin becomes droopy with age. Over time, the skin loses elasticity, loses adherence to underlying tissue, and is affected by gravity.
Brachioplasty may be performed under general or local anesthesia with sedation. It can be performed either in an outpatient surgical suite or a hospital. An overnight stay is usually not required. Before the surgery, the doctor marks the area of excess skin while the patient is standing or sitting. Once anesthesia is administered, the surgeon makes incisions in the inner and under surfaces of the arm. The pattern of skin removal usually follows an elliptical or triangular shape. Some fat may be suctioned at the same time. The surgical incision may run from the armpit to the elbow.
When excess skin and fat are removed, the remaining skin is stretched and sutured into place. A drain is often inserted to lead off excess fluid. The incisions are then bandaged. Surgery lasts one to two hours. You will have to wear a compression garment, a piece of specially designed elasticized clothing that stabilizes tissue after surgery and helps the newly shaped skin adhere to the tissue underneath.
Pain Level/Recovery Time: Many patients experience moderate pain for a few days after the procedure. Prescription pain medications may be prescribed for two to five days; over-the-counter pain relievers such as acetaminophen or ibuprofen should be sufficient for a few days afterward. Avoid strenuous activities, bending, and lifting for the first week after surgery. Swelling may be mild to moderate. Stitches that are not absorbed will be removed after a week. Many people can return to work within a week and can exercise in about a month.
$3527 (national average for surgeon's fees).** Average surgeon's fee for brachioplasty may vary by region:
For New England (CT, ME, MA, NH, RI, VT) and Middle Atlantic (NJ, NY, PA): $3879 For East North Central (IL, IN, MI, OH, WI) and West North Central (IA, KS, MN, MO, NE, ND, SD): $3,245 For South Atlantic (DE, DC, FL, GA, MD, NC, SC, VA, WV): $3,351 For East South Central (AL, KY, MS, TN) and West South Central: (AR, LA, OK, TX): $3,386 For Mountain (AZ, CO, ID, MT, NV, NM, UT, WY) and Pacific (AK, CA, HI, OR, WA): $3,738
** Note: These averages for surgeon's fees are provided by the American Association for Aesthetic Plastic Surgery, Inc. These figures do not include fees for the surgical facility, anesthesia, medical tests, prescriptions, or other miscellaneous costs related to surgery. In addition, most insurance companies do not cover the cost of brachioplasty for cosmetic purposes. Check with your insurance company.
An arm lift can sculpt a new contour of the arm, making many patients feel more confident and comfortable in their clothing. One drawback, however, is that the surgery often replaces one cosmetic problem (saggy arms) with another (scars). Scars may extend from the armpit to the elbow, along the inside of the arm. While brachioplasty is considered permanent, the effects of weight change, diet, exercise, and age may cause skin to sag again in the future.
Brachioplasty is not recommended for individuals who have undergone mastectomy, since lymph nodes, which are responsible for the drainage of fluid from the arm, may already be damaged. Patients who have repeated infections of the armpit or who sweat excessively may also not be good candidates.
The risks associated with brachioplasty include (but are not limited to): a reaction to anesthesia; excessive bleeding; infection; visible scarring; possible asymmetry (unevenness); and possible nerve damage. Discuss these and others risks with your doctor.
It's also important to note that an arm lift does not improve muscle tone. Your doctor can advise you about exercises to tone and firm muscles before and after the procedure. If your problem is heavy arms due to excess fat, diet and/or liposuction may be a better option.
Lori, 35, Miami, Florida
Lori, a hair stylist in South Florida, used to weigh 312 pounds. "When I held my arms up, there was a mountain of flesh hanging underneath. I could never think about wearing sleeveless or a bathing suit without a shirt," she says.
In May 2002, she underwent gastric bypass surgery -- a procedure that reduces the size of the stomach to help people who are extremely overweight lose weight. By last fall, with diet and exercise, Lori had lost 130 pounds. "I was half the person I used to be. I felt great," she says. "But after losing all that weight, you're left with saggy, hanging, disgusting skin. You can tone the muscles underneath, but the skin is still there."
So last October, Lori scheduled an "extreme makeover" of her own -- an arm lift, tummy tuck, and breast lift all at once. The surgery was performed under general anesthesia and she stayed overnight in the hospital. "I wasn't in any pain," Lori says. "My arms were probably the most tender, when I stretched them over my head." She was able to walk around one day after surgery. "I had planned to take three weeks off from work, but I was back in the salon after 10 days. My work is all upper body and arms, and I wasn't in any pain at all," she adds.
The surgeon was able to remove 30 percent of the excess skin, which Lori feels is definitely an improvement. She sports fine scars that lead from inside her elbows to her armpits, but they're fading fast. "I'd rather have the scar than the flab," she says.
The total bill for surgery came to $14,000, which included $5,000 for the arm lift. "My biggest gripe was that insurance covered the gastric bypass but they wouldn't cover the plastic surgery because they say it's cosmetic," Lori says. "It's not cosmetic, it's psychological. When I was fat, I'd put on a bathing suit and jump in the pool. Now I wear bike shorts in the water because it's so depressing to look at hanging flab. You feel gross. It really bothers me." (Lori plans to schedule a thigh lift in about six months -- which she'll pay for out-of-pocket.)
All in all, Lori is happy with the results. "I'm not looking to look like a Barbie doll," she says. "I'm a poster child for the surgery. I had no complications, no issues, no problems." So far, she's recommended her plastic surgeon to at least 25 of her clients. If only she'd get a slice of the pie....
To Learn More: Visit IEnhance.com, and click on Procedures.
Check out the Arm Lift section of InfoPlasticSurgery.com
Visit the Public Site section of the American Society for Aesthetic Plastic Surgery's Web site. Or call their toll-free referral line at 1-888-ASAPS-11.
For physician referrals, call the American Society of Plastic Surgeons referral service at 1-888-4PLASTIC or visit them online. Click on "Learn About Procedures" to find out more.