Brachioplasty is an operation to remove redundant skin and fat from the upper arms. This procedure tightens the remaining skin but leaves a scar along the inside of the arm. The procedure is most suited to people who have lost weight and now have loose, stretched skin around the upper arms
Brachioplasty may be performed as an isolated procedure, taking about 90 minutes, or can be performed in conjunction with other body contouring procedures. It is performed under general anaesthetic and most patients would stay one night in hospital.
The fat is removed by liposuction and the skin along the inside of the arm is then excised. The scar stretches from just above the elbow into the armpit. All the incisions are closed with dissolving sutures which are hidden beneath the skin. The wounds are further supported with a layer of surgical glue and tape. This technique leaves the best scar without the characteristic cross-hatching of external stitches and, of course, no painful sutures / clips to remove. There is usually a fine, soft drain brought out through the end of the scar. This reduces the build up of fluid under the skin and usually can be removed the following day. All dressings can get wet immediately. To reduce swelling in the arm, I recommend wearing an elasticated support garment (Tubigrip or similar) for about 6 weeks following the surgery. This garment will be applied during the surgery and should be worn day and night post-operatively. The garments can be removed to shower.
Bruising and swelling lasts 1-2 weeks. You will have to minimise daily activities following the procedure to allow the wounds adequate time to heal. You should be able to return to light duties after 2 weeks, following a post-operative wound check. Gentle exercises should be started 1-week after surgery to prevent elbow and shoulder stiffness. Strenuous exercise or sporting activity should be avoided until 6-weeks post-surgery. You may be able to drive at 2-weeks. The skin around the scars will feel numb following the surgery. Gradually the sensation will return but it is common to have some patches of permanent numbness.
You will notice a visible improvement in your arm contour immediately, however the final result should be judged 1-year after surgery, once the scars have settled down. The results of brachioplasty are usually very good and long-lasting, but large fluctuations in weight and the normal effects of ageing can lead to recurrence of loose skin over time.
Complications are relatively uncommon after brachioplasty, however the following may be associated with this procedure:
Swelling of the arm which may take a long time to resolve in some people
Bleeding/haematoma (a collection of blood) requiring a return to the operating theatre
Wound infection, delayed healing and fat necrosis (higher risk in diabetics and recent ex-smokers)
Unsightly scarring. Most scars fade to a whit line over a period of 6 to 12 months but some people produce thick, lumpy scars that may be hypertrophic or keloid
Deep vein thrombosis (DVT) and pulmonary embolus (PE) - these are blood clots that may occur in the leg (DVT) and travel to the lung (PE) which may be very serious - fortunately they are uncommon in brachioplasty surgery.
Suture spitting - this refers to the deeper dissolvable stitches poking out of the wound some time after the surgery. This happens because occasionally these stitches do not dissolve as quickly as intended, and they then try to work their way out of the wound. These stitches can either be removed at one of your post-op visits or they may work their way out on their own.
Further surgery may be needed for any of the above.
Further information about this procedure can be found here