Solutions for toning the upper arms: Arm lifts, skin tightening and more

The arms are an area many people become self-conscious about. You've almost certainly heard of the term "bat wings" – the loose, sagging skin that hangs from your upper arms. Some people are so concerned about it that they won't wear certain shirts that expose their arms.

Many men and women can find the appearance of their upper arms not up to their standards, whether they are experiencing sagging skin because of weight loss or the natural skin laxity that comes with age. Yet, there are solutions available to treat the appearance of the upper arms, such as brachioplasty and liposuction.

So, which procedure is right for you, and are they truly effective for all patients? What are the results that can be expected from arm lipo or brachioplasty? ASPS Member Surgeons Ravi Somayazula, DO, and Johnson Lee, MD, filled us in on all the details.

The basics of aesthetic procedures for upper arms

Brachioplasty, also known as an arm lift, may feel like a lesser-known procedure in the world of plastic surgery, but it is actually somewhat commonly requested.

"Of all the procedures that I do, it's certainly not the most popular, but it's moderately popular," said Dr. Somayazula. "I feel like every other week or every week, I receive inquiries about arm lifting."

There are many reasons that patients seek out this procedure, but a majority pursue an upper arm lift after successful weight loss.

"Patients who successfully lost a lot of weight either through exercise, surgery like gastric bypass or medications like Ozempic, but with residual excess skin of the arms are the most likely to request brachioplasty," said Dr. Lee.

Simply put, when you lose weight, there is likely to be excess skin left behind.

"Really, the typical cohort of patients are those who have lost a lot of weight," said Dr. Somayazula. Whether it's diet and exercise-based weight loss, surgical weight loss or medical weight loss, at the end of the day, if you lose enough weight, you're going to get loose skin."

It's important to note that this is a family of procedures that can address multiple concerns. From liposuction to brachioplasty, there are many tools at the disposal of a skilled plastic surgeon. The exact means and method to achieve the desired result depends greatly on the patient's unique body and goals as well as the recommendation of the surgeon.

With upper arm procedures, there are a few methods to address the aesthetic concerns of the patient. For patients who are looking for pure fat removal, liposuction is an easy solution. However, many patients will opt for a more intensive treatment option, such as brachioplasty, which removes excess skin in addition to fat.

"There are two general ways to perform a brachioplasty procedure," said Dr. Lee. "A traditional brachioplasty has a scar that extends from the elbow into the axilla (armpit). The incision is usually designed to sit on the inside of the arm or along the back side. This allows the greatest amount of skin removal along the entire length of the arm. A short-scar technique can also be performed where the incision is designed within the dome of the axilla. This scar is very well hidden; however, it limits the amount of skin removal that can be done. Patients who have limited extra skin within the proximal third of the posterior (back of the) arm are the best candidates for this technique."

Preop and postop recovery processes

Scarring is a reality with any surgery. Your plastic surgeon will take time to discuss options and results to make sure the patient has a full understanding of what scar placement will look like.

"Telling patients about the scar position during the consultation is essential," said Dr. Somayazula. "If you show them what you can do with their arm and don't show them where the scar will live, they will be very unhappy. It's important to talk to them about the length of the scar and scar positioning in the consultation."

Prior to surgery, there is a preop process patients must follow to prepare for the procedure.

"Depending upon how much weight they've lost, we typically just make sure that patients have good nutrition," said Dr. Somayazula. "Typically, we'll draw up bloodwork to make sure that their protein levels are good in order to optimize recovery. If they're diabetic, we'll check hemoglobin levels to ensure proper healing."

After a brachioplasty, there is a mandatory period of rest and recovery. It is of the utmost importance that patients follow the instructions of their surgeon during this process, as doing so will help minimize scarring and maximize their healing time, getting them back to their daily lives more quickly.

"Patients will have restricted movement for the first two weeks of their procedure to minimize any tension on the incisions," said Dr. Lee. "More strenuous activities can begin at four weeks, although patients are still encouraged to gently extend their range of motion to minimize any tension along their incision for the most optimal scar during the first three months after surgery."

Advice for patients considering an arm procedure

With any procedure, your results can only be as good as the surgeon who performed the surgery. Always make sure that you find the right plastic surgeon to help you achieve the results that you're looking for.

"Patients really need to see a board-certified plastic surgeon who does a lot of plastic surgery, but you also need to see someone who does a lot of arm lifts," said Dr. Somayazula. "You have to delve a little further – how many do they do, how many before and afters do they have, etc. I get a decent amount of brachioplasty because I show a lot of before and afters of arm contouring on our website. It's important to show any patient before and after photos either before or during the consultation."

As you evaluate plastic surgeons, it's critical to ensure that you discuss your options during the consultation. Brachioplasty might seem like the best solution, but there may be another, less intensive procedure that will help you reach your goals.

"It is important to review before and after photos with your surgeon to make sure the brachioplasty is right for you," said Dr. Lee. "Not everyone may need a full arm lift to address excess skin. Patients with mild to moderate skin laxity but good elasticity may be candidates for liposuction to debulk fat with additional skin tightening from an energy device such as radiofrequency, such as BodyTite, or plasma, such as Renuvion. This can help some patients avoid the brachioplasty scar."

Any procedure that involves the removal of excess skin will cause scarring, even with the most skilled surgeon. Patients can set themselves up for success and achieve a positive mindset post-procedure by understanding this going into surgery.

"It's a simple procedure – it takes me about an hour to an hour and a half – but it can change someone's life forever in a positive way," said Dr. Somayazula. "Only if they understand that they're trading the scar for the result."

For men and women who are concerned with the appearance of their upper arms, a brachioplasty may be the answer to their worries. These procedures offer the ability to create more tone in the upper arms through the removal of excess skin and fat. A safe and effective field of aesthetic procedures with a high patient satisfaction rating, upper arm lifts are truly a game changer when it comes to self-confidence.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.