Arm Reduction (Brachioplasty)
Arm reduction surgery has become increasingly popular over the last few years, with an increase in the number of people looking to improve their upper limb contouring following significant weight loss or after weight loss (bariatric) surgery. It is often the first procedure requested by patients following bariatric surgery or significant weight loss, as they want to be able to wear sleeveless or short-sleeved clothing without feeling self-conscious.
The operation removes fat and excess skin through a combination of liposuction and surgical removal of tissue. Scarring is hidden in the inner arm and up into the armpit.
Mr Adams will discuss the best technique for you during your consultation.
Before and After Gallery
34 year old, before and 6 weeks after Brachioplasty operation
34 year old, before 6 weeks after Brachioplasty operation
48 year old, before and post Brachioplasty with liposuction
62 year old, before and 6 months after Brachioplasty operation
Arm Reduction
What You Need to Know
Pre-operative Advice
The aims and expectations of surgery will have been discussed with patients at consultation. Smokers have an increased risk of wound healing problems, and therefore should refrain from smoking for 4 weeks before surgery and for two weeks afterwards. Aspirin and related anti-inflammatories (ibuprofen, naproxen, diclofenac) should be avoided for a similar period of time.
The contraceptive pill or HRT should be stopped for 4 weeks pre-operatively.
Before Surgery
Patients are admitted on the day of surgery for pre-op checks by the nursing staff and seen by the Anaesthetist to discuss the general anaesthetic. Mr Adams will take photographs, draw on the arms and take consent. Leg stockings will be provided to reduce the risk of venous thromboembolism. These are worn until patients leave hospital.
During Surgery
The surgery takes 2 hours and is under general anaesthetic. Patients usually stay for 1 night, although they may go home if they live locally.
After Surgery
Drainage tubes are not usually required. Stitches are self- dissolving. Micropore tape is applied over the scars, which can extend from the elbow into the armpit. Soft but bulky dressings are used firmly to wrap up each arm from mid-forearm to shoulder. This can limit movement and may make eating with utensils and toileting awkward. The degree of discomfort is variable but managed with regular analgesia. Expect some mild puffiness to the hands and wrists for the first few days given the firmness of the dressings. Patients should not drive for 1 week. Work should be avoided for 2-4 weeks. Sporting activities may need to be curtailed for 6-12 weeks. The dressings are removed at one week and tap applied by the cosmetic nurse. Showering can resume after one week.
Risks and Complications
As with all surgery, complications can occur. In the initial stages, the main risks are of delays in wound healing or infection. A long-term risk is a lumpy or stretched scar. The scars do take up to one year to fade in colour. Asymmetry of scars may be evident. Whilst numbness may be noted both around the scar and into the forearm, this resolves over a few weeks. Very rarely, there may be a degree of permanent numbness along the inner border of the forearm (lower arm). Another rare observation is that of a cord-like lumpiness along the inner upper arm below the scar. This can be an inflamed vein called phlebitis which resolves without treatment.
Follow-up
Patients are seen at one week for a wound check. An outpatient appointment is made to see Mr Adams at 6 weeks and 6 months.
What Happens When I Leave Hospital?
Stitches are hidden under the skin and self-dissolve. Micropore tape is placed directly over the scars/wound at the time of the operation. Absorbent gauze, wool and crepe dressings are applied firmly. At one week follow-up, the dressings are removed and tape re-applied over the scars for 4 weeks.
The wounds need to be kept dry for 7-10 days. Occasionally a knot of buried, dissolving stitch can make it self known along the scar line. These are best left alone to separate unless they are causing problems. After 4 weeks, the tape can be removed and the scars massaged with a vitamin E containing cream. If the scar becomes very red and lumpy, then other treatments can be employed (steroid injection or silicone gel sheeting or cream).
Patients should expect a degree of discomfort for one week post- operatively. The arm will be tight and is largely due to swelling. The discomfort and dressings will limit some movement and therefore daily activities including eating and toileting. Some numbness around the scars is to be expected, and will resolve over time. If a wound infection is present, this can delay the healing time and may have an affect on the quality and nature of the scar.
Refrain from driving for 2 weeks. Depending on the nature of your work, you may require 2-4 weeks off. Avoid any activities that pull or stretch the scars or upper arms. Avoid vigorous sports for 8-12 weeks
Patients will be seen by the cosmetic nurse at one week following your operation, and then as required. Mr Adams will arrange out-patient appointments for 6 weeks and 6 months to be sent by email.
The main concern with arm reduction surgery is wound infection and breakdown. Should the wound become red, hot and very swollen then please contact the hospital or contact Mr Adams’ secretary for advice.
Resources
Read the full Blepharoplasty fact sheet for more information on the types of surgery, pre-operative advice and what to expect following the procedure.
Want to Know More?
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The first step of your cosmetic surgery journey should be a consultation with your plastic surgeon. It is your chance to get accurate information and professional reassurance, both of which can be hard to find online.
