Brachioplasty (arm lift)

Brachioplasty, or an arm lift, corrects skin laxity between the armpit and elbow. Liposuction may be added in selected cases.

The procedure addresses skin that hangs from the inner arm, which often appears after weight loss or with age. By removing the excess and reshaping the tissues, the arm gains a firmer contour that is more in proportion with the rest of the body. At Detalii Med in Baia Mare, brachioplasty is performed by Dr Marius Pruna and Dr Valeria Pruna, plastic surgeons.

It is considered for patients with persistent excess skin after weight loss or reduced elasticity, ideally at a relatively stable weight.

Suitable candidates usually have:

• loose skin on the arms that does not improve with exercise or diet;
• discomfort when dressing or irritation in the skin folds;
• good general health;
• a willingness to stop smoking in the period around surgery;
• acceptance of a scar that is visible in certain arm positions.

When the main issue is fat and the skin still has good elasticity, liposuction alone may be a more suitable option.

It can reduce folds and improve arm proportion. It is not a weight-loss treatment and requires acceptance of a scar whose length depends on the excess.

Brachioplasty does not tone the muscles and does not stop the skin from ageing. For small amounts of excess limited to the area near the armpit, a shorter incision may be enough. When loose skin extends to the elbow or even towards the chest wall, the scar is longer. The scar is usually visible when the arm is raised or in sleeveless clothing.

Consultation determines tissue distribution, skin quality, scar placement and whether liposuction would be beneficial.

The surgeon discusses medical history, weight changes, medication, smoking and the patient’s expectations. The arms are examined in different positions to see how much the skin hangs and where the scar can be placed as discreetly as possible. The patient receives information about recovery, how long arm exertion must be limited and which tests are needed before surgery.

Excess tissue is removed through an incision along the inner or posterior arm before the tissues are reshaped and closed.

Before surgery, the surgeon marks the skin to be removed with the patient standing. Where indicated, liposuction first reduces the fat in the area. The excess skin is then excised and the wound is closed in layers, with sutures that may be absorbable. The length of the operation varies with the amount of excess, typically from one to several hours. A drain is sometimes placed for a short period.

Depending on extent, surgery is performed under general anaesthesia or according to the plan agreed with the medical team.

Other anaesthetic options may be considered for limited corrections. The choice is made after the pre-anaesthetic assessment, taking into account the patient’s health and the expected length of the operation.

The arms may feel swollen and tight initially. Compression, incision care and a gradual return to exertion are required.

• In the first few days, the arms are kept slightly raised where possible to reduce swelling.
• Compression garments are usually worn for several weeks.
• Light daily activities resume gradually, usually within the first days or weeks.
• Lifting weights and sport that strains the arms are avoided for roughly four to six weeks, according to the surgeon’s advice.
• The scar should be protected from the sun for the first few months.

Follow-up appointments allow healing to be monitored and recommendations to be adjusted.

Risks include bleeding, infection, seroma, wound separation, asymmetry, numbness and widened or raised scars.

Numbness may occur on the inner arm or forearm and usually improves over time, although it can sometimes persist. Small skin excesses at the ends of the scar or minor contour irregularities may remain and occasionally need a touch-up. Swelling of the hand or forearm may occur temporarily. Risks are higher in smokers and in people with conditions that affect healing, so these are discussed openly at consultation.

Contour is apparent early but refines as swelling settles. Scar maturation continues for several months.

In the first weeks, the arms may look swollen and tight. The shape can usually be judged better after a few months. The scar may be red and slightly thickened at first, then gradually becomes flatter and paler, a process that may take a year or longer. The result is best maintained at a stable weight, although the skin continues to age naturally.

Brachioplasty can reduce loose skin on the arms and improve the proportions of the silhouette, at the cost of a scar on the inner arm. It is best suited to patients at a stable weight, and the length of the incision, the addition of liposuction and the type of anaesthesia are agreed individually at consultation.