Brachioplasty (arm lift surgery)

Brachioplasty, or 'arm lift' surgery, reshapes the underside of the upper arm from the armpit to the elbow. The surgery removes extra skin and fat to give a more toned and balanced appearance.

Upper arm skin tends to droop with age, after significant weight loss, and for people with lymphedema. Exercise may strengthen and improve the underlying muscle tone of the upper arm, but it cannot change any extra skin that has lost its elasticity.

If you are concerned about the way you look or are thinking about cosmetic treatments to boost your confidence, there are alternatives. These may include lifestyle changes or learning to accept yourself the way you are.

Before choosing brachioplasty

Before you opt for brachioplasty, some important issues to keep in mind include:

• You will have a scar on the inside of your upper arm, running from your armpit to your elbow. Although the scar may fade significantly with time, it may always be visible.
• Think about the financial cost. Cosmetic surgery does not usually qualify for rebates from Medicare or private health insurance.
• Smokers are at increased risk of complications from any surgery. If you are serious about undergoing cosmetic surgery, you should try to quit smoking.

Finding a brachioplasty medical practitioner

You may want to ask your doctor for advice about finding a suitable medical practitioner or hospital where brachioplasty is performed. At your first consultation, you should ask the medical practitioner about their training and experience. It is preferable to have this procedure done by a medical practitioner who is specially trained to perform brachioplasty and has a lot of experience in carrying out this type of surgery.

Medical issues related to brachioplasty

Before the operation, you will need to discuss a range of medical issues with your medical practitioner. They will talk to you about your:

• physical health – an examination will help your medical practitioner to decide if the treatment is appropriate
• medical history – some pre-existing medical conditions and surgery you've had in the past may influence decisions about this operation, including the type of anaesthetic that is used
• risks and possible complications – it is important that you understand the risks and complications so that you can weigh up whether brachioplasty is right for you
• medication – tell your doctor about any medication that you take regularly or have recently taken, including over-the-counter preparations like fish oils and vitamin supplements
• past reactions to medication – your doctor needs to know if you have ever had a bad reaction or a side effect from any medication, including anaesthesia
• preparation for surgery – the medical practitioner will give you detailed instructions on what you should do at home to prepare for surgery. For example, they may advise you to take a particular medication or alter the dose of an existing medication. Follow all instructions carefully.

Brachioplasty operation

Brachioplasty is usually performed under a general anaesthetic and may take up to three hours. Generally speaking, the operation involves:

• The medical practitioner makes a cut on the inner surface of your upper arm from the armpit to the elbow. (Occasionally, the cut is made on the back of the arm.)
• Extra fat is removed with liposuction, which involves the insertion of a thin tube (cannula) into the fat deposit. The fat is vacuumed out with a suction pump or large syringe.
• Underlying muscle is tightened with stitches to smooth and define the shape of the upper arm.
• The extra skin is cut away.
• The cuts are closed with stitches.

Immediately after brachioplasty surgery

After the operation, you can expect:

• a drainage tube in the wound to help prevent fluid build-up
• bruising and swelling
• possible numbness
• pain and discomfort
• dressings or bandages on your upper arms
• compression garments to help keep swelling down.

Complications of brachioplasty surgery

All surgery carries some degree of risk. Some of the possible complications of brachioplasty include:

• risks of anaesthesia, including allergic reaction, which (rarely) may be fatal
• surgical risks, such as bleeding or infection
• blood clots that may cause potentially fatal cardiovascular complications, such as heart attack, deep vein thrombosis or stroke
• collapsed lung
• fluid build-up under the wound
• tissue death along the wound, or skin loss
• sensory nerve damage, which may cause prolonged or permanent numbness in the upper arm or even in the forearm
• prolonged swelling
• damage to underlying tissues such as muscles
• asymmetry (unevenness) of the skin
• unsightly, inflamed or itchy scarring
• further surgery to treat complications.

This is not a complete list. For example, your medical history or lifestyle may put you at increased risk of certain complications. You need to speak to your medical practitioner for more information.

Self-care at home after brachioplasty

Be guided by your medical practitioner, but general self-care suggestions include:

• Rest as much as possible.
• Follow all instructions on looking after your wound.
• Avoid strenuous exercise or heavy lifting for at least one month.
• You may need to wear your compression garment for several weeks.
• Report any bleeding, severe pain or unusual symptoms to your medical practitioner.

Long-term outlook following brachioplasty

Having a brachioplasty will not stop your upper arms from sagging if you gain and lose a large amount of weight in the future. You must also expect a certain degree of sagging as you age. Scarring will be permanent, but should fade in time. Be patient – improvements to scars may take around a year or so.

Alternatives to brachioplasty

Non-surgical options may include:

• eating a healthy low-fat diet
• exercise
• wearing long-sleeved tops
• accepting yourself – talking to a counsellor or psychologist may help you overcome your concerns about your appearance and you may decide that you like yourself the way you are.

Where to get help

• Your GP (doctor)
• A surgeon specially trained and experienced in performing cosmetic surgery
• Cosmetic surgery hub and hotline, Australian Health Practitioner Regulation Agency (AHPRA) Tel. 1300 361 041
• Cosmetic surgery, Department of Health and Aged Care, Australian Government
• Australian Society of Plastic SurgeonsTel. (02) 9437 9200
• Australasian Foundation for Plastic Surgery Information Hotline Tel. 1300 367 446
• Royal Australasian College of Surgeons Tel. (03) 9249 1200
• Australian Health Practitioner Regulation Agency (AHPRA) Tel. 1300 419 495