Many major weight loss patients feel uncomfortable in short sleeves or sleeveless tops due to the looseness of the skin on their upper arms. This loose skin can also make clothing fit improperly and limit the types of clothing you can wear. The combined effects of aging, gravity, weight loss, and a loss of skin elasticity all contribute to a loss of tone in the arms. Brachioplasty, or arm lift, is a surgical procedure to remove excess skin and fat from the upper arm, reducing skin redundancy and improving the firmness of the skin in the upper arm area. As with all body contouring after major weight loss, it is best to wait until your weight has stabilized with no more than a 5 lb. loss per month over at least three months.
Brachioplasty is specifically tailored to meet the needs of each individual patient. The amount of excess skin and fat present in the upper arms will determine the extent of the incisions required. Rarely, minimal excess skin may be treated with an incision in the armpit alone. Most often, an incision from the armpit to the elbow is necessary to treat moderate laxity. More severe cases are rare and may require extension of the incision past the elbow onto the forearm. If a breast lift procedure is performed at the same time, the incision may be connected to reduce the excess skin on the sides of the breast below the armpit.
The Consultation
Your consultation with the doctor is complimentary and there will never be any charges for office visits. During your initial consultation, you will be asked to give information about your medical history, prior procedures, medications, allergies, and your motivations for seeking plastic surgery. It is very important that you be thorough when providing your medical history, as this information helps to prevent complications during your care. When asked about medications, be sure to include any vitamin or herbal supplements, as these can affect your blood pressure and clotting ability. You also need to let the doctor know if you use any tobacco products, alcohol, steroids, or street drugs, as these may have a profound impact on your recovery period and your ability to heal following your procedure. After reviewing your medical history, Dr. Nguyen will discuss your desired results, your concerns, and your priorities. He will then explain the options that are available to you and explain the advantages and disadvantages of those options. In the end, he will present a surgical plan to help you achieve the appearance you desire.
After your consultation with the doctor, your patient coordinator will provide you with a written quotation for the cost of your procedure. At this time, you will also have the option to schedule your procedure if you so choose. We understand how important this decision is to you and you will not be pressured to make a decision. You are also encouraged to bring your spouse, significant other, family member, or a friend to your consultation.
Preparing For Surgery
On the day of your consultation, you will receive instructions on how to optimize your health before surgery. This will include what medications to stop and what testing will be required before surgery. If you are 45 years of age or older, or if you have any health problems, you will need to see your primary care physician to have bloodwork, an EKG, and obtain surgical clearance stating that there are no counterindications for you having surgery. You should not take aspirin containing products or smoke for two weeks before surgery. If you have health problems or a history of health problems, you may require additional testing or clearance.
If you do not have a primary care physician, we recommend Dr. Chi Phan, located at 4050 Barranca Pkwy Suite 210; Irvine, Ca 92604 Phone: 949-654-7833. Dr. Phan accepts most insurance. For those who do not have insurance, Dr. Phan charges approximately $120 for surgical clearance, including EKG & bloodwork.
The Procedure
Brachioplasty surgery usually takes two to three hours. All sutures are placed beneath the skin and are absorbed by your body, leaving no sutures to be removed by the doctor. A sterile dressing is applied to the incisions, and a compression garment may be placed to support your arms during healing, decreasing postoperative swelling. After surgery, you will recover in the recovery area for approximately one hour, until you are alert enough to go home. There will be tapes over the incision which should remain intact for 2 weeks.
The Day of Surgery
While you're making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed. Your surgery will be performed in our outpatient surgery center at 11190 Warner Avenue, Suite 400; Fountain Valley, CA. You will not be allowed to have anything to eat after 9pm the evening before surgery or drink after midnight the night before surgery. You should shower prior to surgery but do not use any deodorant, lotions, or perfumed products on your arms. You should not bring jewelry, contact lenses, or valuables on the day of surgery. Wear loose, comfortable clothing with a shirt that buttons or zips in the front (we don't want to put anything on over your head when you get out of surgery). Arrive two hours prior to surgery.
After Surgery
For the first day or two you will rest most of the time and limit your upper body activity. You should sleep with your head elevated (approximately 45 degree angle) so that you can get in and out of bed without using your arms. You will begin taking pain medication and antibiotics after surgery. Each time you take your pain medication, you should have a snack as the medication can be irritating to your stomach. For the first 24 to 48 hours you will have a sensitive stomach and you should eat mild foods such as you would normally eat if you had the flu (soups, crackers, etc.). Dr. Nguyen also strongly suggests Gatorade to replenish your fluid levels.
You should plan to significantly reduce your activity for several days following your surgery. You will be limited to light arm movement for approximately one week after surgery. You should not reach or stretch your arms for two weeks. You will notice an improvement in the contour of your arms immediately. However, your shape will continue to improve in the following weeks as the swelling subsides. Your arms will be very sore for several days, but this will subside within two weeks.
You will be able to return to most of your normal (light) activities within a couple of days. You will be able to shower once you feel comfortable being up for extended periods of time without lightheadedness, usually on the third day. The tapes over your incision will protect the incision from the soap and water so you may shower as normal and pat the tapes dry. Patients with an office job are often able to return to work within 7 days. More strenuous jobs may require work restrictions for eight weeks, which you may request a certifying letter from the receptionist.
You should not do any strenuous activities or heavy lifting (over 5 lbs) for 8 weeks after surgery. You will be followed closely for the first three months after surgery and will be advised which specific activities you may resume as your healing progresses. You should able to resume most of your normal daily activities within two weeks following surgery, and you should be able to resume all of your physical activities within eight weeks of surgery.
Once all incisions are well-healed (no scabs or open areas), you may begin applying ScarGuard to the incisions. This combination of hydrocortisone, silicone, and Vitamin E, is applied like nail polish and helps your scars fade as much as possible. ScarGuard is available at the pharmacy in our building.
Your Results
Your arms will be smaller and firmer. You will fit more comfortably into clothing and feel more confident in the way you look in short sleeves. Incisions may remain lumpy and red for months, then gradually become less obvious, flattening out and lightening in color.
The Cost
These fees are approximate and are only to give you an idea of what you can expect. Fees may change without notice. An official binding quote (valid for 30 days) will be given on the day of your consultation. These fees include Surgeon’s Fee, OR Fee, Anesthesia Fee, Surgical Garment, and Follow-Up Visits