Arm Lift (Brachioplasty)
The upper arms become a major problem after weight loss — particularly in the summer when people wear short sleeves. It is definitely more disturbing to see hanging soft tissue and skin after losing part of the adipose tissue than before the weight loss, when everything was tight. This is also referred to as the bat wing deformity. Dr. Rafizadeh performs the arm lift as a combination of liposuction and skin resection, tailored to the severity of each patient's deformity.
“I perform this procedure as a combination of liposuction and skin resection that usually goes from the elbow to the armpit. In milder cases the incision could be limited to the armpit. The scars are on the inside of the arms and usually heal well with minimal visibility. Liposuction alone works in milder cases with tight skin and does not cause a scar.”
— Dr. Farhad Rafizadeh, MD FACS
Dr. Rafizadeh's Three-Category Classification
Category I — Liposuction Only: Minor degrees of arm laxity and excess fat can be addressed with liposuction alone — no skin excision and no scar. Dr. Rafizadeh liposuctions the arm and removes almost all fat from the inside of the arm. The excess skin becomes very obvious and easy to remove if needed, and the skin can be closed without tension with a well-healing scar. This is the least invasive approach and appropriate for patients with good skin elasticity.
Category II — Axillary Excision: When there is too much skin laxity for liposuction alone but the excess skin is primarily in the upper portion of the arm, the skin can be excised under the axilla (armpit). In these cases the hairy skin and sweat glands are removed and the scar is hidden in the armpit. Depending on how much excess skin there is, this can produce a major improvement with a well-concealed scar.
Category III — Full Brachioplasty: When there is too much skin across the full length of the arm, the only way to get a good result is to remove it along the axis of the arm, resulting in a longitudinal scar from the elbow to the armpit on the inside of the arm. A big segment of skin and subcutaneous tissue can be removed and the improvement is dramatic — though the scar, while hidden on the inner arm, is visible when the arm is raised. Dr. Rafizadeh learned a technique from a colleague in Lyon, France who specializes in body contouring after major weight loss.
The Procedure & Anesthesia
The arm lift is performed under local anesthesia with sedation and usually takes one to three hours depending on the extent of correction required. General anesthesia is available for patients who prefer it. The arm is wrapped for a few days after surgery with a compression dressing to minimize swelling.
Recovery Timeline
Days 1–5: The arms are wrapped or a compression garment is worn. Mild soreness and swelling. Light activity is fine but arms are kept elevated when possible.
Week 1–2: Sutures dissolve or are removed. Most patients return to desk work and most normal activities.
Weeks 3–6: Return to full activity and exercise. Avoid heavy lifting until cleared.
Months 1–6: Scars on the inner arm continue to fade and soften.
