An expert overview of arm reduction surgery

Many people feel self-conscious about excess skin around their arm and consider undergoing surgery in order to improve the appearance of the arm. Renowned consultant plastic, cosmetic and hand surgeon Miss Kerstin Oestreich explains the procedure, including preparation and what to expect.

How can a patient prepare for an arm reduction surgery?

Most often patients undergo arm reduction surgery after massive weight loss or in some cases, normal weight loss.

The second group of patients who choose to undergo the surgery are patients who are slightly in their middle ages and/or have skin that gets a bit more lax. This often occurs around the time of menopause; due to hormone changes in the body, the skin gets more lax and less retractable.

Therefore, even if you don’t do a lot of exercise and try your very best to get your muscle tone as defined as possible, the excess skin on your arms, which is normally on the inner side of your upper arms, will not go away. For this reason, in some cases, patients choose to undergo arm reduction (brachioplasty).

How long does the arm reduction surgery procedure typically take, and what can I expect to experience during the surgery?

The procedure is normally either performed under general anaesthetic or under twilight anaesthetic, a very deep sedation where you’re asleep but still breathing yourself.

The surgery takes between 1 ½ - 2 hours, depending on the amount of tissue that we need to resect. The surgery itself is a combination of liposuction, where we reduce a bit of the fatty tissue, and of skin resection.

What are the risks and potential complications associated with arm reduction surgery?

The brachioplasty upper arm reduction leaves you with a very long scar, from the axilla to the elbow. Unfortunately, it is unavoidable, which is the main downside of this procedure. However, with plastic surgery we have meticulous suturing so we make the scar as neat and fine as possible.

With regards to short term risks, there can be swelling of the lower arm, bruising and bleeding. We have to be careful not to damage the nerves that go down the arm. If that happens, there can be a loss of sensation or function of the hand and in worst-case scenario, that can be permanent, although it is extremely rare. Before undergoing the surgery, the patient has to be informed about these potential complications.

The swelling normally goes away after a week or so and we will normally ask you to elevate the arm by putting it on cushions when you’re in bed, which will make them slightly elevated at heart level to avoid the swelling in the first instance. The bruising will go away after a short while.

We use a compression garment, which will also help with the reduction of swelling, bleeding and bruising.  This garment needs to be worn for four to six weeks after the surgery.

What should I expect during the recovery period following arm reduction surgery, and what can I do to minimise discomfort and speed up the healing process?

As previously mentioned, swelling is one of the main problems following surgery, therefore elevation of the arms at both night time and day time as much as possible is important, in addition to wearing a fairly tight compression garment for four to six weeks after the surgery.

Patients should also reduce activities during the first four to six weeks, making sure not to do any heavy lifting. At times we suggest wearing compression stockings to reduce any complications after surgery, such as a blood clot in the leg.

The skin heals in two weeks, and then we cover the scar line with a specific dressing called micropore tape. This is meant to stay on the skin, on the scar for up to 12 weeks. The patient is allowed to shower with this tape on and only dab the area dry and only when the tape falls off, to replace the tape with a new one. This will help with a nice neat scar long term.  

What recommendations will you give to a patient undergoing this procedure?

Any patient who is considering arm reduction, should consider their overall weight; if they are happy with it or if they are planning to lose more weight, because every change in the overall weight will change the arms as well.

Any loose skin doesn’t normally retract on the arms. Ideally, if you consider brachioplasty, it is good to do some gym exercises, to improve muscle tone in the arms and to reduce the weight as much as you want and then we are able to resect the excess skin.

You should avoid any strenuous activity after surgery and if you are planning on having children in the very near future or eventually, you should have them before having the procedure, as any hormone change will change the fat in your body and the skin structure.

If you are considering a brachioplasty and would like to book a consultation with Miss Oestreich, do not hesitate to do so through her Top Doctors profile today.