Upper Arm Lift (Brachioplasty)

An upper arm lift, known by the medical term brachioplasty, removes excess skin and fat from the upper arm to produce a tighter, more defined arm contour. It’s a procedure that’s most commonly considered by patients who have lost significant weight and are left with loose skin hanging from the underside of the upper arm, although it’s also performed in patients with significant skin laxity that has developed through ageing.

Brachioplasty is a procedure that comes with a specific trade-off: the operation removes skin reliably and improves the contour of the upper arm, but it leaves a scar that runs along the inner side of the arm from the armpit toward the elbow. The scar is permanent and is more visible than scars on most other body areas, particularly in clothing that exposes the underside of the upper arm. Whether the improvement in contour outweighs the visibility of the scar is a personal decision, and it’s the central conversation we have at consultation.

Brachioplasty is most commonly considered after significant weight loss, where the skin of the upper arm has been left loose and isn’t responding to exercise. Skin laxity in the upper arm doesn’t improve with resistance training, although exercise does improve the muscle bulk underneath. Patients who have completed their weight loss, are at a stable weight, and have loose skin that’s interfering with how their arm looks or feels are the typical candidates.

Other patients consider brachioplasty for changes that have developed through ageing, where the skin of the upper arm has gradually lost elasticity over time. The amount of skin removed and the scar length are adjusted to the individual situation, with smaller operations (sometimes called mini brachioplasty) suited to patients with less significant skin laxity.

Brachioplasty isn’t right for every patient with concerns about their upper arms. Patients whose main concern is excess fat rather than excess skin are sometimes better served by liposuction (see the Liposuction page) without skin removal. Patients with a tendency to keloid or hypertrophic scarring need to weigh the risk of a poor scar carefully, because the scar from brachioplasty is in a visible location and isn’t easily concealed. We’ll be honest at consultation if we think the trade-offs don’t favour surgery for your situation.

Several different brachioplasty techniques exist, and which one is most appropriate depends on the amount of skin to be removed and where the skin laxity is located.

Brachioplasty is performed under general anaesthesia in an accredited hospital. The operation usually takes between two and three hours, depending on whether one or both arms are being treated and whether liposuction is being combined with the skin removal. Most patients are treated bilaterally (both arms in the same operation), which is more efficient than separate operations and allows the result to be symmetrical.

Most patients go home the same day or stay one night, depending on the size of the operation and the patient’s circumstances. Drains aren’t routinely used in brachioplasty, although they may be placed in larger procedures. Compression garments or wraps are worn on the upper arms continuously for several weeks after surgery.

Most patients describe mild to moderate discomfort for the first few days after brachioplasty, with the pain typically less than after abdominoplasty or breast surgery. Arm movement is restricted in the early days to reduce tension on the suture lines, with patients asked to avoid reaching, lifting, and any activity that requires the arms to move above shoulder height for the first two weeks.

Compression garments are worn continuously for several weeks, including overnight. Lifting, vigorous exercise and activities that involve repetitive arm movement are restricted for around six weeks. Most patients with desk-based work return after one to two weeks, while patients in physical roles that involve significant arm use need longer.

Scars take 12 to 18 months to reach their final appearance, and during that time they typically go through a phase of being more pink or red before fading. The scar position along the inner upper arm is permanent and is more visible than scars in most other body areas, particularly in sleeveless clothing or with the arms raised.

The recognised risks include:

Brachioplasty may attract a Medicare rebate in specific circumstances, most commonly where there is documented significant weight loss following bariatric surgery, with documented weight stability, and where the relevant Medicare criteria are met. Eligibility is assessed on a case-by-case basis. Cosmetic brachioplasty isn’t covered. A written quote is provided at consultation.

Dr Henry Shepherd, BMed MD MS (Plast.) FRACS (Plast.) | Specialist Plastic Surgeon | AHPRA registration: MED 0001860545