Brachioplasty is a body contouring procedure designed to deal with loose and sagging skin of the arms.
Loose and sagging arm skin, also known as “bingo arms” or “bat wings” classically follow significant weight loss but can be due to general effects of ageing. The appearance often leads to embarrassment and concern and I see many patients keen to explore avenues of surgical correction.
The option of liposuction alone is limited with this condition. Liposuction will remove fat, rendering the remaining skin even looser. There are a small group of patients, however, who have large arms with relatively tight skin and may benefit from liposuction alone.
As skin appearance becomes looser, some degree of skin reduction will be necessary in addition to liposuction. In this larger group, a combination of liposuction with skin excision of the upper arm extending into the armpit is the best option.
For many patients with the classic bat wing type of problem, a formal brachioplasty will be required. This will involve an excision or skin tightening from the armpit down to the elbow. While this is a significant scar to accept, this approach will deliver a superior dramatic result.
Modern brachioplasty practiced by Dr Drielsma involves a combination of radical liposuction with skin only excision and tightening. This approach preserves the underlying arteries, viens, nerves and lymphatic tissues and dramaticaaly reduces wound healing problems that have classically been associated with this surgery. Brachioplasty is now a relatively smooth procedure with predictable healing and low complications.
Brachioplasty takes some 3 hours to perform. It is done under general anaesthetic with a one night hospital stay. There are no stitches to be removed as all are dissolving.
Usually 2 weeks will be required off work. Gentle exercises can be commenced after 3-4 weeks, however, vigorous exercise should be avoided for 6-8 weeks. It may take 2-3 months before returning to completely normal activity.
Are there any risks?
As with any surgical procedure, there is a small risk of complications. Surgery and anaesthesia are very safe and it is most unlikely you will experience any difficulty. However, there are areas of potential problems you need to understand before proceeding with your surgery. You can reduce your risk of complications by closely following instructions before and after surgery.
Bleeding: Bleeding can be problematical in about 2% of cases. It is possible in cases bleeding that return to the operating theatre will be necessary and sometimes blood transfusion is required.
Infection: If infection occurs it will usually become evident within one week of surgery and may delay the healing process or result in the development of scar tissue. This may require treatment with antibiotics. In the unlikely event of infection, the ultimate result of the surgery may be adversely affected.
Anaesthesia: The surgery is done under a general anaesthetic and the anaesthetist will be discussing the possible discomforts following anaesthesia. Modern anaesthesia is very safe and risks very rare. Any questions you have regarding your anaesthetic would be best answered by the anaesthetist at the time of surgery.
Scarring: All surgery carries risks and every incision leaves a scar. Scars do however fade remarkably well over a one to two year period and become much less noticeable. The scar of brachioplasty is never invisible but is placed in a position that minimizes its visibility. The nature of this scar will be explaned in full to you before surgery.
The scars will often look red and lumpy at about three months after surgery as they heal but this is normal and will settle over the following 3-6 months. It takes 12-18 months before the scars mature completely, flatten out and lighten in colour.
Sensation: Some change in sensation for up to six months is common as bruised nerves are recovering. Some minor residual permanent alteration in sensation may occur.
Fluid Collection: A seroma is a collection of fluid under the skin and fat. If this occurs it may take a few weeks to absorb. Wearing the pressure garment will help reduce this risk.
Lymphoedema
Lymphoedema is swelling of the arm due to damage to lymph channels from the arm. Using modern techniques as described above which preserve lymphatic tissue, the chance of this problem, once common, is now rare.
Important points to remember before proceeding with surgery:
There can be no absolute guarantee with any surgery. In the hands of any experienced surgeon, a secondary operation to correct a minor irregularity may be needed.
Should there be any questions regarding brachioplasty, be sure they are answered in advance by Dr Drielsma. Well meaning friends are not a good source of information. Find out everything before the operation - a well informed patient is a happy one.
The best candidates for body contouring surgery are those who want to enhance or improve their appearance, not those who seek perfection. You will be satisfied with the results of surgery if you have realistic expectations. It is important that you make the decision to proceed with surgery for yourself, not anyone else.
The next step when considering cosmetic surgery is a consultation with Dr Drielsma. You will be shown before and after photos, your suitability for surgery will be assessed and the procedure will be explained fully to you in detail.
The above information mentions only some of the benefits and complications of brachioplasty. This information should not be regarded as a substitute for information and advice provided by Dr Drielsma during consultation.
Dr Robert Drielsma is a fully qualified Plastic and Reconstructive Surgeon specialising in Cosmetic Surgery and Reconstructive plastic surgery with over 20 years experience.
