Arm Lift (Brachioplasty)

Arm Lift (Brachioplasty)

What is a arm lift?
Substantial weight loss or age can cause the skin on the back of the upper arm to become loose and saggy. Many people become self-conscious of this and are keen to seek improvement to the contour. The extent of the loose skin varies but typically extends from the armpit to the elbow.

An arm lift, or brachioplasty, is a body contouring procedure to reshape the upper arm. At times, the upper arm contour can be improved with liposuction alone, however very often excision of the excess skin is necessary which will leave a permanent scar on the inner-back side of the arm. Some patients with a smaller amount of excess skin may only require a scar hidden along the armpit crease (axilla) or a shorter upper arm scar. Your initial consultation and examination of the upper arms is critical to determining if your a candidate for upper arm contouring.

Pre Surgery Instructions

Before the procedure
No aspirin or blood thinning medications for two weeks prior to surgery. Fasting begins at midnight the night before surgery. Any medications that you take in the AM may be taken with a sip of water (except for blood thinning medications). If you get ill prior to surgery please notify us.

The Surgery

During the procedure
An arm lift is done under general anesthetic and takes roughly 2.5 hours. The scar is designed to be as inconspicuous as possible particularly with the arms at your side. However, with the arms up,, the scar will be visible unless a short scar arm lift or liposuction alone is performed.

The procedure begins with the underlying fatty tissue removed by liposuction and then the excess skin is excised. The amount of skin and the final position and length of the scar varies with each patient, though every effort is made to ensure it’s as short as possible.

A combination of dissolvable and non-dissolvable sutures is used and the arms are gently wrapped at the end of the procedure. A compression garment is started only at week 2 when much of the initial swelling has subsided. This compression garment is worn for 3 weeks.

After Your Surgery

Post procedure
While In Hospital or Clinic
You will be in the recovery room anywhere from 1-3 hours where the team will ensure you are comfortable, eating and drinking, walking and able to urinate.
On discharge home
Immediately upon discharge from the recovery room, you are encouraged to rest under supervision and start a light diet as tolerated.

You will have been given a prescription for antibiotics that is started when you return home from surgery and is taken for 1 week.

The best position for your arms when sitting is on top of 1-2 pillows to try and keep them elevated. Although keeping them elevated all day is not necessary, the more that they are elevated the less swelling ensues.
Day 1
You should be up and walking, drinking fluids, taking your antibiotics and pain medication as described below. Increase activity as tolerated, but there is no heavy lifting for 4 weeks. Leave the dressings alone until your first visit to the office after surgery.
What do I take for pain?
If you have pain, you are encouraged to start with:

Two Tylenol extra strength (total of 1000 mg of Tylenol) and one Advil extra strength (400 mg of Advil) to be taken at the same time as they work by different mechanisms and work very well together.

You can take the above three pills (two Tylenol extra strength and one Advil extra strength) every 8 hours around the clock for the first day or two. This is often sufficient for pain medication and can avoid the need for stronger medications such as narcotics (Percocet, Tylenol #3 etc.).

However, you will also have a prescription for a stronger pain medication that can be taken as needed if the Tylenol and Advil combination mentioned above does not suffice. This stronger pain medication may be taken on top of the above regimen. Please ensure the maximum dose of Tylenol in 24 hours does not exceed 4000 mg.

** Please be aware that with any medication and particularly Advil (a type of non-steroidal anti-inflammatory) there are risks of allergy, severe allergy, gastro-intestinal bleeding and stomach ulcers. Taking your medication with food can sometimes help with some of the stomach symptoms.

A post-operative compression wrap with tensor bandages and the underlying gauze dressings are left in place for 2-4 days. During this period of time, you may use a hand held shower or sponge bath but the dressings must stay dry.
First post-operative appointment
The initial dressing change is done on day 2-4 after surgery. The gauze is removed and the white skin tapes are left on. The tensors are wrapped back on the arms for the first two weeks.
Second post-operative appointment
The second appointment is close to 2 weeks after surgery and the white skin will be removed. The sutures are removed. The compression garment is placed on the arms and used day and night (except for the shower) for the next 3 weeks.

Post-operative swelling and bruising begins to subside after 7-10 days but can take up to 2-4 weeks for the initial 70% of swelling to resolve.

As swelling can persist for 6 months, it will take that long to see the final results particularly where liposuction has been used.

Patients usually require 1-2 weeks of downtime and should avoid strenuous exercise for 4-6 weeks.

Silicone gel sheeting is used for scar management (you will get this from the office) and starts around week 3.

The scars will take 12-18 months to fully mature and fade. Silicone gel sheeting is the best product to help with scar maturation and is used for 2-3 months following surgery.
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