Arm lift — an operation that trades sagging for a scar

An arm lift (brachioplasty) removes stretched skin from the inner upper arm. It is done after substantial weight loss, or when skin has loosened with age.

First it has to be separated from liposuction.

• If fat is the problem, liposuction alone reduces it — provided the skin has the elasticity to shrink to the remaining volume.
• If skin is the problem, there is no route other than cutting it away. Removing fat alone can leave it looking looser.
• Both together is in practice the commonest situation, done at once or in stages.

How much is removed sets the length of the scar.

• A short excision at the armpit only — for a lesser degree of looseness. The scar hides substantially in the armpit crease.
• A long one from armpit to elbow — the commonest pattern. A line remains down the inner arm.
• Continuing onto the side of the chest — after large weight loss, when looseness extends below the armpit.

Let us be plain about how this site writes this operation. An arm lift is not an operation of uncertain effect. Cut the skin away and it is reduced. In that respect this page differs from many others here.

What is clear instead is the price. The scar. This site sorts scarring on surgery pages into none, hidden and visible, and this one is visible. It sits where raising or spreading the arm shows it.

It is done under general anaesthesia, sometimes with drains for several days.

The scar is this operation's largest problem. It is long, badly placed, and widening or thickening is reported more often here than elsewhere, because the line is under tension every time the arm moves. Revision of the scar is sometimes needed. On scar care, see the silicone scar products page as well.

Lymphatics of the arm run through here. Dissecting widely towards the armpit can leave lasting swelling of the arm. If you have had breast surgery or anything done to the axillary lymph nodes, say so — it changes the reasoning.

Sensation can change. Nerves serving the inner upper arm cross the operative field. Numbness is common, and it can persist.

Wounds open here more often than in other sites, because going without using the arm is hard. The end towards the armpit especially.

Fluid collection (seroma), collected blood and infection are reported. That is why drains are used.

The two sides will not be identical. Arms differ from each other to begin with.

This is an operation for a stable weight. A large change afterwards alters the result.

Have the scar drawn on you before surgery. Look at where the line falls with the arm down, raised, and spread out. It is different from hearing it described.

Ask whether it runs on the inner side or the back of the arm. At the same length, the two are not equally visible.

Ask first whether a short incision would do. With lesser looseness, an excision at the armpit alone is sometimes enough.

Check that your weight has settled. After large loss, it is better once it has held for some months.

If anything has been done to your axillary lymph nodes, say it first. It is the most important part of the history here.

Not smoking matters especially here. It bears directly on blood supply and healing along a long incision.

Check in advance how long compression garments are worn. It is measured in weeks.

Put the period without using your arms into your plans. Lifting and raising the arms are restricted for weeks.

The decision here is not 'will it work' but 'can I accept the scar'. Among the operations this site covers, that structure is at its clearest in this one.

Think about summer and about what you wear. It shows in clothes that leave the arms bare. Which bothers you less — visible sagging or a visible line — differs from person to person, and that judgement is yours.

Scars fade with time. But this site takes longer than most, and the first months are the most conspicuous. Give it a year before judging.

Whether your scars tend to widen changes the outcome a great deal. Talk through how previous operations or injuries healed on you.

It cannot be undone. Skin removed does not come back, and the scar stays.

Whether to have it done is settled with a doctor, and it is better not to settle it on one consultation alone.