What Are The Different Types of Arm Lifts, Arm Reductions, or Brachioplasties?

WHAT IS A BRACHIOPLASTY?

A brachioplasty goes by several names, like an arm lift or reduction. A brachioplasty is a plastic surgical treatment done to tighten and reduce the size of the upper arms.
Excess upper arm skin and fat are removed during the arm lift procedure.

WHO NEEDS A BRACHIOPLASTY?

If you have extra drooping skin and fat in the upper arm region, you may consider a brachioplasty. Excess upper arm may result from natural aging, significant weight loss, sun damage, or heredity. There are five types of arms for patients seeking arm reduction surgery.
Type 1: These patients have excellent upper arm skin contractility, are under 35 years of age, possess minimal arm stretch marks, and have some upper arm fat.

Type 2: These patients have excellent upper arm skin contractility and have isolated fat in the upper one-third of the arm next to the armpit.

Type 3: These patients have excellent upper arm skin contractility and isolated fat in the upper half of the arm.

Type 4: These patients have excess upper arm fat and loose skin from the armpit to the elbow. This type of arm patient typically has loose upper arm skin due to massive weight loss, genetics, or solar damage.

Type 5: These patients have excess upper and lower arm fat and loose skin to the wrist. Usually, these types of patients have undergone massive weight loss and have genetic components to their excess arm skin.

HOW MANY DIFFERENT TYPES OF BRACHIOPLASTIES ARE THERE?

There are SIX different types of brachioplasty surgeries. Each type of arm lift surgery depends on a patient’s arm anatomy and their wishes for the final arm lift results.

1) VASER ARM LIFT

WHAT IS VASER ARM LIPOSUCTION/LIFT?

Patients with Type 1 arms are best treated with VASER arm liposuction. VASER is a liposuction instrument that uses ultrasonic energy to melt arm fat and heat the underlying surface of the arm skin. By melting fat, more fat can be removed. Also, heat-shrinking skin over muscle yields the best arm contour results.
Studies have shown that the VASER yields superior results compared to traditional arm liposuction in terms of results, less bruising, less swelling, and less bleeding. The VASER arm liposuction/lift is best for patients with Type 1 arms.

WHAT TYPE OF ANESTHESIA IS USED FOR VASER ARM LIPOSUCTION/LIFT?

General anesthesia is best when undergoing VASER arm liposuction. Dr. Katzen uses board-certified anesthesiologists for his patients undergoing VASER arm liposuction.

WHAT EXACTLY HAPPENS DURING VASER ARM LIPOSUCTION/LIFT?

You are brought into the operating room and undergo IV sedation. Once you are completely asleep, a breathing tube is placed. Your arms are prepped with an antiseptic and sterile draped. Several tiny incisions are made in strategic points to access the upper arm fat and intersecting muscle bellies. Then, the tumescent solution is injected. The tumescent solution minimizes bleeding and reduces pain. Also, the tumescent solution allows for an aquatic medium for the VASER to work effectively. Skin protection ports are placed. The VASER probe gets hot and can transmit burns to the skin, so plastic protective skin ports are essential. The VASER is inserted through the skin post, and the VASER energy is applied to stubborn pockets of arm fat and fat surrounding the arm muscle bellies. The fat is melted in the triceps region and the intersections between the deltoids, biceps, and triceps. Then, the VASER probe is removed, and a liposuction cannula (surgical straw) is inserted to remove arm fat. By carefully sculpting away the fat around the arm muscles, the liposuction cannula accentuates the arm muscle bellies. When the tumescent solution and fat are removed, the skin ports are removed. Usually, the skin incisions are left open. The skin incision sites are left open to drain any residual fluid. An arm compression garment is applied. Then, you were awakened from anesthesia and transported to the recovery room.

HOW LONG DOES THE VASER ARM LIPOSUCTION/LIFT TAKE TO COMPLETE?

VASER arm liposuction takes about two to three hours to complete.

WHAT IS THE RECOVERY LIKE AFTER VASER ARM LIPOSUCTION/LIFT?

After VASER arm liposuction, your arms will be swollen for six to eight weeks. At two weeks, most of the arm swelling will be gone. The rest of the swelling will take some extra time to decrease. To minimize post-operative arm swelling, please keep your hands above your heart, your elbows extended, and wear your arm garment. During the healing phase, it will be essential for you to receive a lymphatic massage. Usually, lymphatic massage is initiated one to two weeks after VASER arm liposuction. Arm lymphatic massages are continued for approximately two to three weeks, depending on an individual’s swelling. In addition, it will be essential for you to wear your arm compression garment for a minimum of six weeks. Suppose you have swelling six weeks after your arm liposuction. You may need to continue lymphatic massages and your arm garment in that case.

Most patients can return to a sitting job one or two weeks after arm VASER liposuction. Suppose your job entails heavy lifting and manual labor. In that case, consider taking off for two to three weeks before returning to work.

2) CRESCENT ARM LIFT/BRACHIOPLASTY

WHAT IS A CRESCENT ARM LIFT/BRACHIOPLASTY?
During a crescent arm lift, a crescent-shaped area of skin and fat is removed from the upper third of the arm.
It is called a crescent arm lift because the shape of the skin excision looks like a crescent. The crescent arm lift scar is hidden in the armpit. Some plastic surgeons call the crescent arm lift a “mini arm lift.” The crescent arm lift is ideal for patients with Type 2 arms.

WHAT TYPE OF ANESTHESIA IS USED FOR CRESCENT ARM LIFT/BRACHIOPLASTY?
General anesthesia, provided by a board-certified anesthesiologist, is given for a crescent arm lift.

WHAT EXACTLY HAPPENS DURING CRESCENT ARM LIFT/BRACHIOPLASTY?
For a crescent arm lift, you are brought to the operating room, undergo IV sedation, and general anesthesia is established. Your arms are sterilized and surgically draped. Once you are completely asleep, an incision is made in the armpit. Careful measurements are taken before another counter-incision is made. Skin and fat are removed from the outer armpit to six to eight centimeters down the upper inner arm. The upper arm skin that is removed looks like a piece of cantaloupe. The upper inner arm skin is carefully dissected, and the skin edges are sutured together in multiple layers using absorbable or dissolvable sutures. Drains are not required. Sometimes, arm liposuction is incorporated with a crescent arm lift.

HOW LONG DOES THE CRESCENT ARM LIFT/BRACHIOPLASTY TAKE TO COMPLETE?
The crescent arm lift takes about two to three hours to complete. The crescent arm lift procedure will take longer if arm liposuction is involved.

WHAT IS THE RECOVERY LIKE AFTER CRESCENT ARM LIFT/BRACHIOPLASTY?
With a crescent arm lift, there is significant tension in the armpit. During your arm recovery, you must keep your arms by your sides with your elbows pinned to your torso. After the crescent arm lift surgery, you will be placed in a garment and a wrap to keep your arms by your sides. Some patients feel like a Tyrannosaurus Rex because their elbows are stuck to their sides, and they have limited movement of their forearms. You will need to maintain this position for about three weeks. After the first week, your arm garment will be changed, and the incisions examined. Local wound care will be applied for two to three weeks. After a crescent arm lift, most patients can return to a desk job for one to two weeks. If you have a very physical job, postpone returning to work for at least three to four weeks. Usually, lymphatic massage is not necessary after a crescent arm lift unless arm liposuction is involved.

3) MODIFIED INCISION ARM LIFT/BRACHIOPLASTY

WHAT IS A MODIFIED INCISION ARM LIFT?
During a modified incision arm lift, an incision is made from the arm pit down the inside of the arm. The incision is placed in the crease between the biceps and the triceps. An elliptical area of upper arm skin and fat are removed. The length of the incision depends on the individual’s amount of excess upper arm skin. Sometimes, liposuction of the fat around the elbow is combined with a modified arm lift. Patients with Type 3 arms may be good candidates for a modified incision arm lift.

WHAT TYPE OF ANESTHESIA IS USED FOR A MODIFIED INCISION ARM LIFT?
During a modified incision brachioplasty, general anesthesia is used.

WHAT EXACTLY HAPPENS DURING A MODIFIED INCISION ARM LIFT?
Once you are asleep from the anesthetic, your arms will be sterilized with solution and draped. An incision is made in the arm pit and extended down the inner arm. Dissection is carried to the back of the arm and an ellipse of excess skin is created. This ellipse is resected and the surgically created wound is closed in multiple layers with absorbable sutures. Drains are not used. The arms are wrapped in gauze and an ACE bandage or a garment is placed.

HOW LONG DOES THE MODIFIED INCISION ARM LIFT TAKE TO COMPLETE?
A modified incision arm lift takes about three to four hours to complete.

WHAT IS THE RECOVERY LIKE AFTER A MODIFIED INCISION ARM LIFT?
During the first several days, your arms will be swollen, bruised, and mildly painful. Your pain should be easily controlled with prescribed pain medication. After the first several weeks, your arm swelling and pain will dissipate. During the first two weeks, to minimize swelling, you should keep your arms elevated with your hands above your heart and keep your elbows straight. Plan to take off two weeks before returning to a desk job. If you have a very physical job, plan to take off four weeks.

4) MODIFIED T-INCISION ARM LIFT/BRACHIOPLASTY

WHAT IS A MODIFIED T-INCISION ARM LIFT?
A modified T-incision is an arm surgery procedure that is slightly more than a crescent arm lift and a modified arm lift. Like a crescent arm lift, part of the modified T-incision is made in the armpit. However, with the modified T-incision, another incision is made perpendicular to the crescent incision and extends down the inner arm. Basically, a modified T-incision is a combination of the crescent and modified arm lift. Sometimes, the modified T-incision is carried several centimeters down the inner arm; sometimes, the modified T-incision is carried halfway or two-thirds down the inner arm. The length of the modified T-incision depends on the amount of excess arm skin. The final resulting scar looks like the letter “T” with the horizontal component in the armpit. The modified T-incision arm lift is catered to patients with Type 3 arms.

WHAT TYPE OF ANESTHESIA IS USED FOR A MODIFIED T-INCISION ARM LIFT?
General anesthesia is used for the modified T-incision type of brachioplasty.

WHAT EXACTLY HAPPENS DURING A MODIFIED T-INCISION ARM LIFT?
During a modified T-incision arm lift, you will be wheeled into the operating room and put to sleep. General anesthesia is used. Once completely asleep, your arms will be made sterile with antiseptics and draped with surgical drapes. An incision is made high in the armpit. Tissue dissection is carried down the inner arm. Skin flaps are mobilized, and an area shaped like the letter T is removed. The skin that is removed consists of armpit skin and upper arm skin. The incision length from the armpit down the inner arm depends on the amount of excess skin. The resected skin flaps are brought together with multiple absorbable sutures. Drains are not necessary. Then, you are placed in an arm garment and wrapped to keep your arms at your sides.

HOW LONG DOES THE MODIFIED T-INCISION ARM LIFT TAKE TO COMPLETE?
Completing a modified T-incision arm lift takes about three to four hours.

WHAT IS THE RECOVERY LIKE AFTER A MODIFIED T-INCISION ARM LIFT?
Like the crescent arm lift recovery, you must keep your arms by your side during your modified T-incision arm lift recovery. Keeping your arms by your side for at least three weeks will be necessary. This post-operative positioning minimizes the strain on the crescent portion of the modified T-incision. Because of tension lines, the modified T-incision has a higher chance of wound breakdown than the crescent arm lift. Like the crescent arm lift, you must keep your elbows by your sides.

Approximately one week after your modified T-arm lift incision, the dressings will be changed. To minimize arm swelling, you must wear your compression garment for about six weeks after a modified T-incision. Usually, lymphatic massage is not necessary.
5) PARTIAL LONGITUDINAL ARM LIFT/BRACHIOPLASTY

WHAT IS A PARTIAL LONGITUDINAL ARM LIFT?
A partial longitudinal arm lift is a type of brachioplasty performed for patients with more skin than patients needing a modified T brachioplasty. During a partial longitudinal arm lift, arm liposuction is performed with an incision from the armpit to the elbow. Excess skin and fat from the entire upper arm are removed during this procedure. This procedure is termed “partial” because the incision only goes from the armpit to the elbow, not the wrist. The procedure is named “longitudinal” because the incision is parallel with the longitudinal axis of the arm. The partial longitudinal arm reduction is best suited for patients with Type 4 arms.

WHAT TYPE OF ANESTHESIA IS USED FOR A PARTIAL LONGITUDINAL ARM LIFT/BRACHIOPLASTY?
General anesthesia is required for a partial longitudinal brachioplasty. An anesthesiologist provides your general anesthesia.

WHAT EXACTLY HAPPENS DURING A PARTIAL LONGITUDINAL ARM LIFT/BRACHIOPLASTY?
During a partial longitudinal arm lift, you are brought to the operating room and placed under anesthesia. Once you are asleep, your arms are prepped with an antiseptic. Your arms are wrapped in sterile drapes. Your arms are suspended to allow full access to the upper arm. Tumescent liposuction is performed from the armpit to the elbow. Once the arm liposuction is completed, an incision is made from the elbow to the armpit. A large elliptical area of upper arm skin and fat is removed. The layers of tissue are closed with absorbable sutures. Usually, drains are not used.

HOW LONG DOES A PARTIAL LONGITUDINAL ARM LIFT/BRACHIOPLASTY TAKE TO COMPLETE?
The partial longitudinal brachioplasty takes approximately three to four hours to perform. Larger arms may require more time to complete.

WHAT IS THE RECOVERY LIKE AFTER A PARTIAL LONGITUDINAL ARM LIFT?
After a partial longitudinal arm reduction, recovery entails keeping your elbows straight and your hands above your heart. This position helps to minimize the swelling. Approximately one week after the initial surgery, your arm dressings will be changed. Dressings should be changed daily for the next two or three weeks. Depending on your arm’s swelling and healing, you will be placed in an arm garment. After your arm surgery, you must wear your arm garment for at least six weeks. If you have arm swelling after six weeks, you must continue wearing your arm garment. Most patients can return to work one to two weeks after a partial longitudinal brachioplasty. If your job entails heavy lifting or manual labor, plan on a three- to four-week recovery before returning to work.

6) FULL OR COMPLETE LONGITUDINAL ARM LIFT/BRACHIOPLASTY

WHAT IS A FULL OR COMPLETE LONGITUDINAL ARM LIFT/BRACHIOPLASTY?
This type of arm lift is reserved for patients with excess upper and lower arm skin and fat from the armpit to the elbow. Upper and lower arm liposuction is performed during the full or complete longitudinal arm lift. Sometimes, there is a substantial amount of fat. In that case, liposuction may be completed once or twice before the formal arm lift procedure. During the complete arm lift, an incision is made from the armpit to the elbow and then to the wrist. This procedure is named “full” or “complete” because an incision is made along the complete upper arm. The complete longitudinal arm lift is suited for Type 5 arms.

WHAT TYPE OF ANESTHESIA IS USED FOR A COMPLETE ARM LIFT?
General anesthesia with a board-certified anesthesiologist is used for a complete arm lift.

WHAT EXACTLY HAPPENS DURING A COMPLETE ARM LIFT?
You are brought to the operating room and placed under anesthesia. Your arms are prepped with antiseptic and draped. Once wholly asleep, a small incision is placed in the middle of your inner arm. Tumescent fluid is injected throughout the upper inner arm. Another incision is made in the inner elbow. The forearm is injected with tumescent fluid. After waiting about 20 minutes, liposuction is performed on the upper inner arm and the inner forearm. Fat is removed with liposuction, which aids in the dissection.

Then, an incision is made from the armpit to the elbow. This incision is made in the crease between the biceps and the triceps. Tissue dissection is carried to the back of the arm.

The excess arm skin is removed, and the remaining arm is rotated into the crease between the biceps and triceps. Then, the incision is carried from the inner elbow to the outer lateral wrist (the pinky side of the wrist).

Sometimes, the incision around the elbow is straight; sometimes, the incision is made in a semi-circle around the elbow to protect the ulnar (think funny bone) nerve. Sometimes, the incision is made in a semi-circle to maximize your ability to bend at the elbow after surgery. Tissue dissection is carried out laterally over the forearm, and the skin of the forearm is then rotated up. Excess forearm skin is removed. The upper and lower arms are closed with dissolvable sutures in multiple layers.

Drains are not used. Yellow gauze (Xeroform) is applied to the incision, followed by a surgical pad and a roll of dressings. ACE bandages from your wrist to your armpit provide mild to moderate compression. You are awakened from anesthesia.

HOW LONG DOES THE COMPLETE ARM LIFT TAKE TO COMPLETE?
The complete arm lift takes longer than the standard crescent of the partial arm lift. On average, the arm lift takes seven to eight hours.

WHAT IS THE RECOVERY LIKE AFTER A COMPLETE ARM LIFT?
Since the complete arm lift involves the entire arm, the recovery is more prolonged. Plan on a three- to four-week recovery. Keep your elbows straight and your hands above your heart for the first two weeks to reduce swelling. You are encouraged to open and close your hands to decrease hand swelling further.

After the second week, you should be able to perform small tasks like feeding yourself and brushing your hair.
After the fourth week, you should be able to carry small items. You should return to about 50% exercise capacity in four to six weeks.

By six to eight weeks, you should be able to return to about 90–100% exercise capacity.

WHAT TESTS ARE NEEDED FOR AN ARM LIFT?
There are standard tests that are required for any routine surgery. These tests include a complete blood count, electrolytes, EKG, chest X-ray, and urine test.

WHO CAN GET AN ARM LIFT?
If you are concerned about your arms or have loose, hanging arm skin, you may be a candidate for an arm lift.
Before an arm lift surgery can be scheduled, a physical consultation with an experienced plastic surgeon will be essential.

HOW DO I SCHEDULE AN ARM LIFT CONSULTATION?
Please call Dr. Katzen’s office TODAY at (310) 859-7770 to schedule an arm lift consultation. Dr. Katzen can arrange for a confidential, private, one-on-one physical consultation. Alternatively, Dr. Katzen can arrange a virtual consultation through Zoom, Skype, WhatsApp, or FaceTime. During your consultation, Dr. Katzen will analyze your arms and determine your arm type. Additionally, Dr. Katzen will decide what arm reduction surgery best suits your arms.
Since 2000, Dr. Katzen has been performing arm lifts.

Dr. Katzen has performed over 1000 arm lifts and has over 150 brachioplasty patients proudly displayed on his website. Trust Dr. Katzen with your arms. CALL TODAY and get the arms of your dreams!