Brachioplasty to tighten and re-shape the arms

Individual results vary*


A beautiful attractive arm has many dimensions and depends on if you are looking at a male arm or a female arm.

In a women the arm is usually considered attractive if it has tight skin. Some definition of muscles and contours but not too much. The arm should also be in proportion to the rest of the body.

Firm, finely-contoured arms contribute to the shapeliness and elegance of the upper body area. With the loss of muscle firmness due to aging or sagging skin from massive weight loss, your arms can suffer from a drooping appearance.

The excessive loose skin and fat can make it difficult for you to wear the clothes you like or feel totally comfortable peeling off in the summer; it can even hamper your movement.

Arm lift or ‘brachioplasty’ surgery restores firmness, balance, and symmetry to the arms. It restores elasticity and tone to the skin.  It is a procedure that completely reshapes the underside of the arm: from the armpit down to the elbow, it removes excess skin and fat and creates a more contoured and balanced appearance.

An arm lift may be especially attractive if you have undergone massive weight loss, and if no amount of exercise has helped you achieve the results you wanted.

Arm lift surgery is sometimes combined with other procedures such as liposuction and breast surgery, where much of the upper body is re-contoured for a more balanced appearance. This is sometimes called an ‘extended arm lift’.

In a man the muscle should be more defined and with no loose skin and also in proportion to the body.

Dr Beldholm sees many women and men that are concerned with the appearance of their arms. The most common patients that Dr Beldholm sees are;

  • Women or men that have lost a lot of weight and have loose hanging skin on the under-arm area
  • Women that have a saggy underarm area, also referred to as the bat-wing appearance
  • Men that want a more defined arm and enhancement of the muscles

The most common group that Dr Beldholm sees are women with excess skin and fat on the underarm area. Many are very embarrassed about the appearance of their arms. Many have rashes and are very uncomfortable doing normal activities. Then there is the appearance of the arms. Many hide the arms in baggy clothes and are embarrassed to show them.

This is one of the most satisfying operations because the difference after the surgery is massive. New techniques and improvement in equipment have also made the recovery better as well as improved scars and appearance after the surgery. Many come in after their brachioplasty surgery in short sleeve shirts and with a smile on their face.

*Individual results vary

Most patients experience the following results from surgery:

  • The removal of loose skin in the upper underarm area.
  • A less flabby appearance to the arms in general.
  • Increased comfort in the upper arm area when you walk or exercise.

What are the options to get a beautifully shaped arm?

There are 2 main options for reshaping and tightening the arms

  • VASER liposuction
  • Arm lift also referred to as a brachioplasty

Dr Beldholm Talking ‘Arm Lifts’ On The Morning Show

Individual results vary*

Arm reshaping with VASER liposuction

Liposuction alone can make a big difference in the appearance of the arm. VASER is a modern method of liposuction. VASER is a ultrasound based liposuction method that in addition to removing fat also tightens tissues.

If you have excess fat in the underarm area and good quality skin, then you will find that this method can give you a great result.

In men the VASER liposculpture can be combined with fat injection over the pectoralis muscle to enhance the appearance of this muscle.

Dr Beldholm has a specialised VASER liposculpture clinic in Newcastle, where you  can have this procedure performed under local anaesthetic and sedation.  Alternatively you also have the option of having it performed in a Private Hospital under a full general anaesthetic.

Modern brachioplasty with Dr Beldholm

Arm lift conference talk Cosmetex 2013

There are many different techniques when it comes to arm reduction surgery. The traditional technique involves cutting the tissues down to the triceps muscle and then creating two so called flaps, where the skin and fat is then resected. Drains are then used to prevent seromas and the drains usually stay in for around 2 weeks.

The problem with this older approach is several fold;

  • High seroma rate (fluid collection in the wound)
  • Need to use drains for several weeks at times
  • Higher rate of nerve damage
  • Not removing fat from the arm. I.e. not getting a sculpted result.

Dr Beldholm has developed a refined Liposuction based method for arms lifts that improve many of the limitations of the more standard or traditional techniques.

Individual results vary*

VASER liposculpture of the arm

The initial step in the operation is extensive liposuction of the arm. The benefit of this is removal of excess fat as well as sculpting the arm and defining muscles. Using VASER liposculpture minimises bruising and damage to nerves and lymphatics. This creates a smoother result that heals quicker.

Removal of excess skin

The loose skin that remains is then removed superficially.  This is key to the refined result and quick recovery.

As there is no deep dissection performed there is no need for drains.

Benefits of having your arm lift performed using the modern method:

  • Day stay operation
  • No drains
  • Quicker recovery
  • Less bruising and swelling
  • Absorbable sutures, no need to have anything removed
  • The scar can be placed in a number of locations depending on your preference

Many different names for arm lift techniques

If you have done a google search for arm lift, you may have noted many different names for the different arm lift techniques. Most of the names refer to the type of scar that is left behind, and not so much the internal techniques.

Dr Beldholm’s technique is very different from the standard techniques, and in Dr Beldholm’s experience the best results are usually when the scar is made as long as is needed. If the scar is made smaller than necessary then there will be excess skin and fat, that is referred to as “dog ears” that will make the arm look lumpy.

VASER liposuction based arm lift

This is Dr Beldholm’s technique, and it has evolved from liposuction based arm lifts, and also the non-excisional brachioplasty that Dr Beldholm has performed for the last 10 years. The VASER has added additional improvements in recovery times, less bruising and better healing. There is also better shaping and definition of the arm. The scar is located on the underarm area and is not usually visible from the front. The scar fades and is usually a fine line at around 12 months after the surgery. The so called Superficial fascial system is closed with permanent sutures providing support for the tissues long term, thereby improving scaring and the shape of the arms.

Hidden/Minimal incision brachioplasty

In this type of brachioplasty the incision is in the axilla avoiding an incision along the arm. If combined with liposuction of the arms, it can give you some additional tightness. The main benefit of this technique is that there is a very limited scar. The main downside is that only a small amount of tightness can be achieved. Dr Beldholm rarely uses this technique as most of Dr Beldholm’s patients have significant excess skin and would not get a good result with this technique.

Traditional brachioplasty

This is also referred to as the standard brachioplasty. This is the most commonly used technique. There is no liposuction performed. An incision is made in the underarm area. The tissues are dissected down to the triceps muscle. The skin and fat is then undermined on both sides and the excess skin and fat cut out. Drains are placed in in the tissues and they are stitched up with deep and superficial stitches. The drains are usually kept in for around 1-2 weeks.

Extended brachioplasty

This is a similar operation to the traditional brachioplasty. In particular, after massive weight loss, there is usually extensive loose skin on both the chest area and the forearm area.  Skin is resected from the chest and forearm area with this operation.

Fish-incision brachioplasty

This operation is used with patients that have a lot of excess skin. At the end of the each scar the incision is extended in a Y pattern. This makes it possible to excise more skin than with only a single scar.

Non-excisional brachioplasty

Despite its name there is still a scar in this operation. (check out the article here: As the standard brachioplasty technique has a very high seroma rate, this is an attempt to minimise the seroma rate. Liposuction is done under the skin that is to be excised. The skin is deepithelialized, this means taking the top layer of skin off but leaving the deeper layer. This allows apposition of the skin without having to cut any tissue out.

The most important layer in the arm when doing an arm lift is the superficial fascial suspension layer. This layer provides stretch to the closure of the skin and prevents the skin from widening with time. It also allows the arm incision to be closed tightly creating a tight arm. Dr Beldholm has performed several of the non-excisional brachioplasties. The biggest problem with this technique is that there is not enough tightness in the closure, so the cosmetic result is compromised, and there is still sagginess remaining. As the main incision is not supported by the a strong fascial closure, the skin excision tends to widen out more as well.

Superficial fascial system suspension

Lockwood T. “Brachioplasty with superficial fascial system suspension.”, Plast Reconstr Surg. 1995 Sep;96(4):912-20.

Although this technique is now quite old and superseded by more modern techniques. The principles are critical. The superficial fascia in the arm is critical in getting a good result in an arm lift. Closing the fascia provides support to scar and minimises widening out of the incision long term.

Recovery after VASER arm liposuction and Brachioplasty surgery

Recovery times from full arm lift surgery will vary from individual to individual, but you should be able to return home on the same day as your operation, after a post-op check by Dr. Beldholm.

You will be provided with a tight-fitting compression garment to wear for up to four weeks following surgery, in order to protect your arms.

The advanced surgical techniques used means that you should be able to return to non-manual work within two weeks of your surgery. Return to manual work and physical exercise will take up to a month.

Over the next few months the scars on the underside of the arm will heal, leaving only a fine line that is almost imperceptible.

With a ‘mini arm lift’, scarring is minimal and recovery times are much quicker.

When can I go back to work and exercise after an arm lift?

Most patients in non-manual jobs return to work after 2 weeks. Heavy lifting and vigorous upper body exercise should be avoided for at least 4-6 weeks.

Complications after Arm reduction surgery

Brachioplasty is usually a safe operation performed as a day stay procedure. However, as with all surgery there is a potential for complications. Most complications tend to be minor and in Dr Beldholm’s experience mostly related to the incision with minor wound related issue.

The procedure will result in scar formation, as with all surgery. With a brachioplasty the scar is on the inner aspect of the arm and, depending on how much skin is removed, it can extend through the axilla and onto the lateral chest wall, as well as towards the forearm. Scarring is generally pink, but fades to become white, soft and supple in the weeks or months after the operation. Most patients find that the wound heals quickly and that the appearance is ultimately acceptable to them. However, abnormal scarring occasionally occurs within the skin and deeper tissues, and these may be unattractive and of different colour to the surrounding skin.

Postoperative pain will occur in varying degrees, from quite severe to moderate to mild on the first day. It gradually improves over the next few days and is usually well tolerated by patients if they take the painkillers prescribed. Increasing pain unresponsive to pain-killers should be brought to the attention of the surgeon as this may be an indication that complications are developing. Intermittent mild discomfort or intermittent sharp pains after the first few weeks after surgery is also common, as the swelling resolves and the nerves recover. Chronic pain, ranging from mild aching pain to sharp nerve pain can persist for more than one year, but is very rare.

Specific complications relating to arm lift surgery may include:

  • Seroma or excessive fluid build-up between the skin and underlying tissue.
  • Nerve injuries, including the motor nerves (such as the ulnar nerve) that move the muscles.
  • Initial loss of skin sensation in the arm – though usually temporary, in rare cases it can be permanent.
  • Visible skin contour irregularities, wrinkles, depressions, and skin pleating, where there is excessive redundant skin.
  • Swelling of the forearms and hands, and skin discoloration.
  • A sensation of tightness in the arm, which usually subsides over time.
  • Infections – either superficial or deep. The infection rate for arm lift surgery is about 1% and the problem is usually easily corrected with antibiotics.
  • Bleeding after surgery – requiring emergency treatment to drain accumulated blood or a blood transfusion.


  1. Egrari S. “Brachioplasty: A Personal Approach.”, Aesthetic Surgery Journal. 36(2):193-203, 2016 Feb.
  2. Ferraro GA; De Francesco F; Razzano S; D’Andrea F; Nicoletti G. “Modified fish-incision technique in brachioplasty: a surgical approach to correct excess skin and fat of the upper arm (restoring the armpit contour).”, Aesthetic Plastic Surgery. 39(2):203-8, 2015 Apr.
  3. Lockwood T. “Brachioplasty with superficial fascial system suspension.”, Plast Reconstr Surg. 1995 Sep;96(4):912-20.

*Disclaimer: Individual results may vary. All surgery carries risks and you should seek a second opinion before proceeding.