The skin of the inner side of the arms, which is very thin, is heavily "stressed" by movements and in the event of significant or repetitive weight variations. This explains why, whether or not associated with fat hypertrophy, skin sagging is frequently observed in this region.
When there is a sagging of the skin at this level, an isolated liposuction cannot be sufficient and only a re-tensioning of this excess skin is likely to correct the defect: it is the brachial lifting or brachioplasty or lifting of the inner side of the arm.
The intervention then aims to reduce fat infiltration through liposuction but also to remove excess skin and redrape the remaining skin in order to tighten it effectively.
Duration of hospital stay
The procedure can be performed on an outpatient basis.
Average length of stay
The duration of the intervention is on average one and a half hours."
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A very careful clinical examination will make it possible to define the most appropriate type of intervention for your case (choice of incision, opportunity or not of an associated liposuction).
Precise information on the procedure, the consequences and the foreseeable outcome of the intervention will be given during the first consultation. In particular, the location of the residual scar will be well explained to you.
A regular preoperative check-up is carried out in accordance with the prescriptions.
The anaesthetist will be seen in consultation at the latest 48 hours before the operation if a general or "vigil" anaesthesia is chosen.
No medication containing aspirin should be taken within 10 days of the procedure.
A skin preparation (such as antiseptic soap) is usually recommended the day before and the morning of the procedure.
Depending on the type of anesthesia, you may be asked to fast (do not eat or drink anything) 6 to 7 hours before the procedure.
Type of anaesthesia:
The lifting of the inner face of the arm can be performed under general anaesthesia under local anaesthesia supplemented by tranquilizers administered intravenously ( "vigilant" anaesthesia) or in some cases under pure local anaesthesia.
The choice between these different techniques will be the result of a discussion between you, the surgeon and the anaesthetist.
The procedure can be performed on an "outpatient" basis, i.e. with discharge the same day after a few hours of supervision.
However, in some cases a short hospital stay may be preferable. Entry is then in the morning (or sometimes the day before in the afternoon) and discharge is authorised the next day.
Each surgeon adopts a technique that is unique to him/her and that he/she adapts to each case to obtain the best results.
However, common basic principles can be retained.
In all cases, fat infiltration, when it is excessive, is first corrected by liposuction. The excess skin is then removed leaving a scar whose location and length depend on the extent of skin distension and the type of procedure chosen.
The incision can be vertical, longitudinal running at the inner surface of the arm or horizontal in one of the folds of the armpit. The two types of incisions can be combined.
Arm lifting with longitudinal incision along the inside of the arm
This intervention is mainly intended for major skin sagging with a clearly expressed motivation: in addition to the aesthetic discomfort (discomfort to wear short sleeves due to the crumpled or collapsed appearance of the arm) the motivation is also often functional (discomfort to mobility or clothing, redness or maceration of the inner surface of the arm).
A first liposuction is performed whenever there is a fat infiltration of the area.
The excess skin is then removed on request from a longitudinal incision along the inner surface of the arm. The importance and topography of this excess will have been identified and drawn preoperatively with the patient's collaboration.
The duration of the intervention is on average one and a half hours. It varies according to the extent of the improvements to be made.
This therefore requires a particularly rigorous selection of surgical indications, good information of the patient and the collection of truly informed consent.
Considering the disadvantages of this type of lifting from the scarring point of view, we try to offer, whenever possible, a less ambitious but more acceptable procedure from a scarring point of view: it can be either a lifting with an isolated incision in the armpit or a mixed technique combining an incision at the axillary cavity and a short vertical segment of less than 10 cm.
Arm lifting with horizontal incision in the armpit
This type of procedure is intended for patients with less significant lesions with excess and sagging skin mainly affecting the upper third of the arm.
From a single, horizontal incision hidden in one of the folds of the armpit and after a first liposuction has been performed if necessary, the excess skin is removed from the upper part of the inner part of the arm. The suture in the armpit hollow allows the residual skin to be redraped and tightened upwards and in the axillary region.
The residual scar is usually not very visible but the morphological result is less spectacular than that obtained with a vertical scar lift.
The duration of the intervention for this technique is on average one hour.
This operation being lighter than the previous one, it is almost always performed on an outpatient basis, either under simple local anaesthesia or under "vigilant" anaesthesia.
Mixed or combined technique
It is a combination of the two previous methods, for which it makes a compromise both in terms of advantages and disadvantages, particularly for scarring.
This technique combines a horizontal incision in the hollow of the armpit and a short vertical scar of less than 10 cm on the inner surface of the arm.
In all cases, at the end of the operation, a bandage is made using adhesive elastic bands or a compressive bra is placed.
The discharge will generally take place on the same day or the day after the operation.
Following surgery, bruises and edema (swelling) may appear. They will regress within 10 to 20 days of the procedure.
Pain is generally very bearable with treatment adapted to the type of tightness or slinging aches and pains.
The healing period may be a little unpleasant due to the tension on the edges of the suture: during this period, any sudden stretching movement should be avoided.
The duration of the necessary work interruption will take into account the nature of the professional activity. Sedentary work can often be resumed after a few days.
The practice of a sport can be gradually resumed from the 4th post-operative week.
The scar is often pink during the first three months and then generally fades after the 3rd month and gradually for 1 to 2 years. This evolution depends on the intrinsic properties of each patient.
It must be protected from the sun and UV rays for the first three months.
A good correction of fat infiltration and sagging of the skin is most often observed, which significantly improves the morphology of the arm. The functional improvement is also very clear, especially in the case of a lifting with a longitudinal incision.
Scars are usually visible, mainly with regard to the longitudinal component on the inner surface of the arm, which is not hidden in a natural fold and cannot be concealed by short sleeves.
Thanks to the improvement of techniques and experience gained, the results of this intervention have improved significantly.
Thromboembolic accidents (phlebitis, pulmonary embolism), hematoma, infection, delayed healing, skin necrosis, sensitivity changes.
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