The Hardest Body Part to Treat – Upper Arms

As a Board Certified Plastic Surgeon specializing in body contouring, I have performed cosmetic surgery on every possible body part – and some you didn’t even know existed. By far, the hardest body part to treat is the upper arms. This area is particularly susceptible to changes in weight and advancing age. This is because the skin is very thin and can sag easily. The result can be unsightly sagging and drooping that can be mild or very severe. My patients refer to their large sagging upper arms as “bat wings”.

Treating this area is difficult,not because we don’t have any options. It is difficult because the gold standard – upper arm lift or brachioplasty – works very well but can leave a long scar down the inside of the arm. This scar is hidden when the arms are down at your sides, but the scar is visible when the arm is raised. If you are willing to accept this scar, then there is no better procedure out there for giving you the slimmer arm you have always wanted. This is the only legitimate option for true “bat wings.” However, many people find that this scar is not worth the surgery, so what are the other alternatives?

Another option is a short-scar brachioplasty. This is designed to reduce the excess skin of the arm, but keep the scar completely with in the underarm area. While this sound like a good idea, it is not as easy as it sounds. Because the scar is only within the underarm, the amount of excess skin that can be removed is limited. This is therefore not a good option for people with significant excess skin. Also, gravity tends to make the scar migrate out of the underarm area and can make it more visible than it is designed to be. This is a good option for mild to moderate skin laxity.

Occasionally, liposuction is an option. This is a good option for young people with good skin quality and only small to moderate amounts of fat and very little skin laxity. Liposuction will remove the excess fat but will not remove excess skin. You must be very careful, too much fat removal can make the appearance of the upper arm worse. Some liposuction techniques can provide added skin tightening, such as laser liposuction. This is a good option if moderate fat is your problem and not excess, hanging skin.

Another weapon in the fight again the upper arms is externally applied radiofrequency. I use a device called REACTION from VIORA. This system is excellent in reducing fat and tightening the skin. Clinical studies demonstrate a 55% improvement. Again this is only an option for mild skin laxity of the upper arms. There is no downtime, no scarring, and no discomfort. A series of 3-5 treatments is necessary and occasional touch up sessions may be needed.

So, what if you have moderate fat and excess skin but do not want the long visible scar? Many of these modalities can be combined to give you good results with less scarring. For example, I have been performing laser liposuction of the upper arm to remove fat and help tighten the skin. Then, about 4 weeks after the procedure, we begin a series of externally applied REACTION treatments to add even more tightening of the skin. This combination works well and has virtually no scarring, but the results may not be as good as a surgical brachioplasty if the amount of excess skin and fat is significant. Some people would benefit from a combined liposuction and short scar arm lift procedure. Again, REACTION can always be added afterwards to help improve the results.

Contact us to learn more about your options for improving your upper arm and to schedule your consultation with Dr. Schulman, call 212-289-1851

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