Arm Laxity

An aesthetic arm is one that conveys the image of youth, athleticism and good health. It has taut, elastic skin with a thin layer of subcutaneous fat covering the underlying muscle and bone. It is often desirable for men and increasingly so in females, to have visible, sculpted contours of the deltoid, biceps, and triceps muscles. Other women may desire arms that have smooth, fusiform contours that run from the shoulder to the elbow.



How Does It Manifest?

Weight loss individuals often have significant skin laxity in the inner arm. The skin folds start from the axilla (underarm) and extend for a variable distance, towards the elbow. This is sometimes described as a “batwing” appearance when the arms are held up. These skin folds sometimes extend into the upper chest. They obscure underlying muscle contour and are generally unsightly. Individuals also often have coexisting fat deposits in the inner and outer arms leading to irregular arm contours. Individuals may be shy about wearing clothes that expose their arms and are conscious about raising them.

How does it arise?

The inner arm skin has naturally few fibrous attachments to the underlying muscle. With weight loss, childbirth, or advancing age, there is thinning of the skin and the subcutaneous fat layer. This results in excess unsupported skin that droops vertically downwards and creates the visible deformities. There are also persistent areas of fat deposits in the inner and outer arms that do not disappear with weight loss; this is due to alterations in the metabolism of adipocytes (fat storage cells).

How is Arm laxity in Weight loss individual different?

Arm laxity following weight loss is often much more extensive and severe than in regular post-pregnancy or aging individuals. Special skin excision techniques are needed to ensure maximal excess skin excision while minimizing the scar burden to achieve attractive postoperative outcomes. The skin in weight loss individuals is thinner and may require longer healing time than average individuals. Specialized wound care techniques may be required in these cases to optimize wound healing and minimize scarring. Intimate knowledge of these anatomical and physiological differences and tailoring the treatment accordingly delivers optimal and bespoke outcomes.

The MY Brachioplasty (Arm Lift)

Brachioplasty (arm lift) removes skin excess in the inner arm and upper chest and reduces of remnant fat deposits through well-concealed scars in the inner arm. The MY Brachioplasty is a surgical technique developed at Picasso Plastic Surgery that achieves maximal skin excision through a short scar. This is an outpatient procedure that may be performed under intravenous sedation or general anaesthesia.

The following are good candidates for brachioplasty:

  • Stable weight for at least 3 months
  • Normal or near-normal BMI with localized fat deposits

Individuals who have a high BMI may wish to consider other forms of weight loss interventions (e.g. diet and exercise interventions, or bariatric surgery) to achieve ideal weight prior to brachioplasty for best results.

Brachioplasty restores the arm contour by excising excess droopy skin while minimizing scar visibility. High-definition liposuction techniques may be applied at specific areas to accentuate the muscle contour (e.g. the deltoid groove), and fat obtained from liposuction may be grafted into the muscles to augment muscle bulk. These techniques enhance the athletic, toned appearance. Brachioplasty permits many individuals to dress in sleeveless, or short-sleeved clothes that were previously not possible prior to surgery.

Individuals are advised to stop herbal supplements and traditional medicine, and start special medications 7 days prior to surgery to minimize bruising and swelling.

The location and amount of excess skin and fat are determined preoperatively, and the proposed scar marked out. Liposuction, if required, is performed through small incisions made at the back of the elbow. It is performed using specialized cannulas that break up, and then aspirate the fat. The excess skin and fat is excised, taking care to preserve important nerve and vascular structures in the inner arm. The amount of skin to be excised is a fine art: sufficient to create a pleasing contour, yet within appropriate limits to avoid excessive wound tension and complications. In individuals requesting for high definition of the arm, additional 5-mm incisions are performed to facilitate liposuction and fat grafting, to accentuate the junctions between the arm muscles.

Minor postoperative bruising and swelling is expected, which will mostly resolve after the 10th postoperative day. Many individuals are able to return to work after the 3rd postoperative day.

Stitch removal is not required as the stitches used are self-dissolving. Showering is possible from the second postoperative day onwards. Bruising may be minimized by avoidance of strenuous activity for the first 14 days. Specific post-operative compression garments may be required in the first 14 days to minimize postoperative bruising and swelling, guide the shrinkage of skin and prevent formation of irregular skin folds.

The Picasso Advantage

Post-weight loss arm contouring is a niche and emerging field within plastic surgery. The MY brachioplasty technique is a proprietary method used exclusively at Picasso Plastic Surgery. It utilizes a unique skin excision design for the maximal reduction of arm and axilla (underarm) skin while concealing most of the scar within the axilla, without the need for extension of the scar into the upper chest as is the case for conventional brachioplasty surgery. Dr Yeo is regularly invited to speak on post weight loss contouring at plastic surgery conferences in the Asia Pacific region.

Our clinic has an en suite operating facility that has MOH certification as an Ambulatory Surgical Center (ASC). An en suite operating facility within the clinic assures your maximal privacy and convenience and keeps facility and equipment costs contained. Our operating room carries a full range of equipment tailored for Brachioplasty and aimed at delivering an optimal result.