
BRACHIOPLASTY (ARM REDUCTION OR ARM LIFT)
OVERVIEW
As we grow older, arm tissue relaxes and descends with gravity and weight loss. The drooping of skin is from a stretching of the anchoring fascial system and loss of supporting fat. This can result in a significant hanging skin underarm to the elbow. Treatment for this is known as Brachioplasty, an Arm Lift, or Arm Reduction Surgery.
PROCEDURES
Who is the best Candidate for Arm Lift/ Brachioplasty Surgery?
Redundant skin folds can predispose areas to infections of the skin or fungal dermatitis. Excessive redundant folds of skin and fat can also cause difficulty of fitting into clothing, interference with personal hygiene, impaired mobility, as well as psychological concerns of a disfigured appearance. Healthy men and women of all ages with excessive upper arm heaviness are candidates for this surgery, provided their expectations are realistic and that they understand all aspects of this procedure including all risks and complications. Brachioplasty will leave a scar that extends from under the arm to the elbow. This scar will fade with time, however will rarely disappear completely and may be visible in certain types of clothing.
WHAT TO EXPECT
You will need to obtain a referral from your General Practitioner, regardless of whether surgery is performed for cosmetic or medical reasons.
Medical patients: If performed for medical reasons, Arm Reduction can attract Medicare rebates. In this situation, a percentage of your Surgeon’s, Anaesthetist’s and Hospital fees may then be claimed from both Medicare and your private health fund if you have cover. Medical patients only require one consultation with our Surgeon, where you will be assessed for suitability. Be frank in your discussion with the Surgeon and remember to mention any relevant medical history and medications that you are taking and if you are a smoker.
Following this consultation, you will be able to speak further with our Cosmetic Consultants, who are very experienced in the cosmetic field and discuss any issues with them.
Criteria for medicare eligibility includes:
- Loss of a significant amount of weight (5 Body Mass Index points) and
- Suffering from a skin conditino due to excess skin (eg irritation, rashes) and have unsuccessfully tried non-surgical treatments for at least three months;
- Excess skin and/or fat interferes with daily activities; and
- Weight has been stable for at least six months.
Cosmetic patients: If performed for cosmetic reasons, you will require two consultations at our Practice. At the initial consultation, you will undertake an assessment for Body Dysmorphia, a condition causing intense focus, shame and anxiety over perceived body defects. At this appointment you will also be given the paperwork for your possible surgery and go through this with our practitioner, discussing the procedure and associated risks and recovery requirements. Be frank in your discussions and remember to mention any medications that you are taking and whether or not you are a smoker.
At your second consultation, we will assess you for surgery. Following this consultation, you will be able to speak further with our Cosmetic Consultants, who are very experienced in the cosmetic field and discuss any issues with them.
SURGERY
Brachioplasty is usually performed on both arms and requires the use of a General Anaesthetic. This Surgery can be performed as Day Surgery, or an Inpatient stay of at least one night may be recommended.
The arm lift procedure begins by marking the area of excess skin. An incision is made underneath the arm from near the underarm region extending down to the elbow region and a wedge of skin and fatty tissue is excised with nerves and blood vessels carefully preserved. In some instances, some light feathering with a Liposuction cannula is performed to produce a smooth result. The edges of the wound are brought together and then sutured. A drain is inserted adjacent to the wound to collect excess blood and serum that collects in the area over the next few days. A dressing is applied to the arm and is kept intact until removed for observation by nursing staff or Surgeon the following day. This scar will fade with time, however will rarely disappear completely and may be visible in certain types of clothing.
RISK
All surgery carries inherent risks and complications and it is especially important that you understand and accept these risks prior to proceeding. Our Plastic and Reconstructive Surgeons have considerable experience in this procedure and all efforts will be taken to minimise risks. Despite this, a small number of complications do occur. Your Surgeon will discuss risks associated with your procedure during your consultation, and this information can also be found in your Informed Consent paperwork.
The most common complication following Brachioplasty is infection along the suture line. This is managed by antibiotics and in some instances you will be given some antibiotic prophylactically to limit the occurrence of this complication. Severe infection may lead to wound breakdown, skin loss and scarring which may require further treatment in the form of debriding or grafting. Other risks include scarring, haematoma and seroma (a collection of blood and fluid under the skin), nerve injury, asymmetry, pain and nausea.
AFTER SURGERY – RECOVERY
Brachioplasty is invasive surgery and has a significant recovery timeframe and limitations and aftercare requirements. You will have an opportunity to discuss recovery expectations with your Surgeon at your Consultation and will receive detailed information prior to surgery in your Informed Consent paperwork.
You will need to organise a responsible adult carer to take care of you in the first three to seven days following your Surgery. This person will need to take you home from the Hospital and assist you in traveling to and from your nursing appointments, as well as assist in your general care at home.
Follow-up care and wound checks are performed by our nursing staff at our rooms on a regular basis in the post-operative stage. You will have dressings around your arms for the first 24-48 hours, drains attached to your wound, and arm sutures or staples. These will be monitored and removed at your post-operative appointments.
Pain may vary from mild to severe and will be managed by your Surgeon with pain relief. Swelling, bruising and nausea is also likely. These will subside as the days go by.
You will be unable to drive for up to two weeks following your surgery and unable to lift and strain for up to one month. You will be allowed to move your arms more freely. You will need to sleep with your arms elevated slightly for about one week to assist in prevention of swelling and resolution of bruising.
As each case proceeds on its own merit, your surgeon will guide you as to when you may recommence specific activities. Expect to take two to three weeks away from your workplace, or longer if your job involves lifting or raising the arms over your head.