Body

Brachioplasty

This procedure is helpful in the treatment of sagging skin on the underside of the arm. Non-smokers in good health who wish to remove loose skin on the underside of the arm, which may be present due to aging, genetics, or weight loss are suitable candidates for this procedure.

Exercise certainly can be beneficial in toning of muscle and shedding fat, but skin laxity in the upper arms will not benefit. For patients desiring tightening of the skin of the upper arms, surgical excision is often the best choice.

Patients actively engaging in weight loss are encouraged to defer their surgery, if possible, until their weight is stable. If significant amount of weight is lost after surgery, some laxity of the arm skin may recur.

Patients with smoking histories should be aware that a history of substantial exposure to nicotine over several years results in harm to circulation to tissues in the body; this can result in wound healing complications.

Patients with any significant medical problems are advised to seek medical clearance prior to surgery.

During the consultation with Dr. Casso, the proposed incision lines are discussed. Patients should be aware of where the scars will be. Many patients wear clothing that conceals their loose arm skin. Patients who would likewise feel compelled to hide scars from surgery are discouraged from having the procedure.

The upper arm lift (brachioplasty) is performed under general anesthesia at Houston Methodist St. John Hospital. While this procedure is sometimes performed in outpatient facilities, Dr. Casso recommends Houston Methodist St. John, which provides the patient with close, expert nursing attention, the availability of intravenous pain control, treatment of postoperative nausea, if present, and immediate medical attention in the event of any unforeseen emergency. The option for surgery in a full-service, state-of-the-art facility such as Houston Methodist St. John provides patients with a measure of safety and security which is unmatched.

Dr. Casso marks his patients in the standing position in the morning just before surgery. The proposed incision lines are chosen carefully to minimize their appearance when the arm is alongside the body.

This procedure involves an incision that extends from near the elbow to the armpit. While there are some techniques which confine incisions to the area of the armpit, in the opinion of Dr. Casso, results with these techniques are sub-optimal. Dr. Casso removes the unwanted skin and fat and carefully sutures the incision. The procedure normally takes about two hours. A bulky dressing is applied. Patients typically are discharged home the afternoon of the procedure. Pain is generally moderate, and controlled with oral pain medication.

This procedure is often performed in conjunction with other body contouring procedures, such as abdominoplasty and breast lift surgery.

The patient is seen in the office the day after surgery and the dressings are changed. Soon thereafter, the patient may shower and apply a lighter dressing and compression wrap. The sutures are removed within the first 10 days, in most cases. Most patients may return to light work within a week. The swelling and bruising of the arm gradually diminishes over three to four weeks and all swelling is generally gone in three to six months. Aerobic exercise is permitted within a week; stretching of the arm skin is discouraged for 4-6 weeks.

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