Arm Lift

Overview

Another name for arm lift is brachioplasty. It is a procedure used to remove loose, saggy skin of the upper arm. Typically, it is most useful in patients who have undergone significant weight loss and are left with hanging skin that has lost its ability to stretch back. It can also be used in older people whose skin is unusually inelastic and has become loose for reasons other than weight loss. The way Dr. Cruise performs the procedure, the arm lift is a two part procedure. The first component is removal of excess skin along the inside of the upper arm and within the armpit. The second part is a suspension of the underlying tissues so that sagging in the future is less likely to occur. Both procedures are done during one operation. It should be mentioned that this procedure is not for everybody as it tends to leave a thick, noticeable scar along the inside of the upper arm. Therefore, as with any procedure, you must weigh the pros and cons before you make a decision. This decision making will be made much easier during consultation with Dr. Cruise and ICRS. You must be willing to accept a long scar on the inside part of your arm (the part that is not usually seen) as a trade off for removal of the hanging skin.

Dr. Cruise’s philosophy regarding Arm lift

The most important aspect of this operation is to find out exactly what the patient’s expectations are. It is an excellent operation to remove excess skin, however, it is not appropriate when there is a significant amount of subcutaneous fat. If you think you will lose more weight in the future it may be more appropriate to wait until that time. In fact, the operation becomes much easier after weight loss. The operation, itself, should not be considered a weight lost procedure. If you do have fat in the upper arm that you would like removed, we can talk about a combination of weight loss and liposuction.

Benefits

To the patient with a significant amount of loose, hanging skin, the arm lift can be an extremely satisfying procedure.

• Arm lift is very effective at removing loose, hanging skin of the upper arm.
• It can liberate from being forced to wear baggy, long sleeved shirts.
• It can provide the confidence to wear more revealing eveningwear that hasn’t been considered prior to the surgery.
• Aside from the cosmetic advantage, it can reduce arm diameter allowing to fit into shirts that were once too tight.
• It can help reduce under arm rash.

Possible complications

The most common problem with arm lifting is a thick scar. It is strategically placed on the inside of the arm where most people cannot see it. Other complications include inadequate skin resection, contour defects, blood or fluid collection, and infection.

Are you a good candidate?

The best candidate is the patient with a significant amount of loose skin in the upper arm without much fat. If you can grab the skin of the upper arm and pinch it so that your fingertips almost meet with just a thin amount of fat in between, you probably are a good candidate. In an overweight patient, the presence of subcutaneous fat makes an arm lift not practical. In this case, would be a consideration. However, it must be mentioned that liposuction is not very predictable in the upper arm region. The ideal patients are those who have just lost a significant amount of weight and their skin is not able to stretch back.

Prior to Surgery

BEFORE SURGERY

• Avoid sunbathing for 2 weeks prior to surgery.
• Quit smoking at least 6 weeks prior to surgery as nicotine can impair and delay healing.
• Stop all aspirin containing products, medications that contains blood thinners (Motrin, advil etc.) vitamin E and herbal supplements 2 weeks prior to surgery. You can take 1 multivitamin a day.
• Let the doctor know of all medications taken daily.
• Make sure all requested labs, and doctors clearance are delivered to Dr. Cruise’s office on time.

THINGS TO PURCHASE BEFORE SURGERY

• Medications.
• Garment. You need to purchase a surgical garment for your arms at contourmd.
• ScarLess®. ScarLess® is a prescription strength cream with vitamin E, silicone and Hydrocortisone to help minimize redness and elevation of the scars. You can purchase ScarLess® at our office.
• Gauze. Make sure to have a box of 4×4 gauze. You can purchase this at drug store.

Optional

1. Arnica – available at our office – may decrease bruising, or help it to go away faster. Patients with high blood pressure should not take this herb.

THE DAY OF SURGERY

• Do not eat anything for 8 hours and drink for 6 before surgery.
• You may shower and shampoo your hair the night before or morning of your surgery.
• You may brush and rinse your teeth, but do not eat or drink anything. Do not wear makeup or moisturizers on your face or eyes.
• Do not bring any jewelry or valuables with you on the day of surgery.
• Wear comfortable, loose-fitting clothes, preferably button up or zipped up top. Wear flat, comfortable shoes. Remove contact lenses, dentures and nipple rings before surgery.
• Someone must drive you home and stay with you the first night.
• Take 2 pills of Zofran and 2 pills of Celebrex at 1-2 hours before surgery.

Anesthesia

Dr. Cruise uses only board certified anesthesiologists to make sure you have the best anesthesia possible. The anesthesiologist will discuss with you what type of anesthesia is best for you. He/she will take into consideration your medical history, the procedure, and your personal wishes. Typically, the procedure is done under general anesthesia. It can, however, be performed under local with sedation depending on the amount of skin that needs to be removed.

After the procedure

The procedure itself will take approximately 2-3 hours.

AFTER SURGERY

Get plenty of rest and limit yourself to light activitie

• Get plenty of rest and limit yourself to light activities the first 10 days after surgery. Sleep and rest with head slightly elevated for the first 3 days.
• You may take a cool shower the day after surgery. Make sure you have someone helping you. Let water run gently over the drains exits. Dab dry. Place gauze over drain exit. Put garment back on.
• At 2-3 weeks after surgery take your steri-strips off. Apply ScarLess®, allow it to dry and then re-apply silicone sheets twice a day for two months.
• Sutures will dissolve on their own.
• Do not drive for the first week or while on pain medications. Do not do heavy housework and do not work out at all for the first 3 weeks, no upper body workout for at least 8 weeks.
• Avoid lifting anything heavier than 5 pounds for 2 weeks.
• Wear a surgical garment for 8 weeks unless Dr. Cruise instructs you differently.
• Avoid direct exposure of incision to sunlight for at least 6 weeks. After 6 weeks, apply sunscreen (at least SPF 15) to the area of the incision, if you will be in the sun for extended periods of time.
• Do not smoke for at least 1 week after surgery.
• Do not use aspirin-containing products for at least 1 week. You may take Tylenol or pain medication as prescribed.
• You may apply ice or frozen peas or corn on the arms for the first 48 hours to decrease swelling. Do not apply it directly on your skin.
• Be sure to use all you medications as directed.
• It is not uncommon for a small part of incision to open up and look like a pimple at 4-8 weeks. This is called a Stitch Abscess – it is caused by a suture which is expelled by the body. Simply wash it with soap and water and apply Neosporin or Polysporin on it. If the redness is larger than a dime call the office.

WHAT TO EXPECT AS YOU RECOVER

• Immediately after surgery, some patients feel groggy or nauseous. These feeling normally subside by the next day.
• Many patients experience some pain for the first 3-4 days and soreness for the first 2 weeks.
• Swelling and bruising usually clears up within 2 weeks.
• Scars will take 1.5 years to mature. They will be the most red at 8-12 weeks.
• Rippling and unevenness around incisions is common. This will flatten out about 3 months.

WHEN TO CALL US

Post surgical complications are rare and are often easily solved by the doctor if you notify us. Call us if you experience any of the following:

A temperature of 101 F or higher, increased local redness or warmth, chest pain, shortness of breath, legs swelling, calf pain, or if you feel that anything might be wrong. Please call the office during regular business hours @ 949-644-4808 after page Dr. Cruise @ 714-304-8050.In addition, call if you have continuous discharge from the incision line, if one of the arms appears significantly larger and more tender, if the pain increases instead of decreasing after 5 days.

POST-OP VISITS AND CARE SUM

Blood Clot	It is important to walk at least every 2 hours while you’re awake to prevent blood clotting- do not over do it. Right after surgery you will be instructed to walk around every 1 hour. Pay specific attention to Leg Swelling. If you notice swelling on only one leg or calf pain contact the office.
Drain Function	Make sure that your drains are functioning. Empty drains every 8 hours or when they become more than half full and write down amount of drainage. Do not be concerned if the fluid from the body comes around drain. You may need to milk the tube if it appears to be clogged. Drains come out at about 2-3 days, depending on amount of drainage. Note – the drain is always uncomfortable but it is absolutely necessary to prevent fluid accumulation.
Constipation	If you are constipated at day 2 stop taking Vicodin or Darvocet. Encourage walking, drinking a lot of fluids, consider laxative( Ex-lax or Correctol).
Fever	Make sure to cough and breath deep as fever is usually in lungs for the first 3 days after surgery.
Activity	You can take a cool shower the day after. Dab dry. Make sure you have someone helping you. Walk every hour while awake for the first day and then every 2 hours Sleep at 45 degree angle for the first 3 nights. Regarding exercise: If it hurts don’t do it. Wait for your body to tell you what you can do. You can exercise areas other than your chest at 2 weeks.You can work out your chest at 8 weeks.
Wound Care	Make sure your garment is on as directed. Keep surgical area clean and dry at all times. At 2-3 weeks after surgery take you steri-strips off. Apply ScarLess®, allow it to dry and then apply silicone sheet twice a day for two months.

Recovery time

Typically, patients are able to return to work 1 week after an arm lift. If your job, however, requires strenuous arm movement it may take 2 to 3 weeks to return.