Arm Lift
Arm Lift Surgery
Arm lift surgery, which has an important place among arm aesthetic surgeries, is an operation that is not performed very often. The most important reason for this is that it is difficult to hide the surgical scar.
In Which Situations Arm Lift Is Performed?
Especially in summer, wearing sleeveless clothes has increased the interest in arm aesthetics in women. Wide and muscular arms in women do not look very pretty and are not frequent. However, excessive weight gain and aging cause sagging of the arm skin. When the arms are brought parallel to the ground, the skin that hangs down makes the arm look thicker than it is, and the swaying skin here does not look nice.
To Whom Its Done?
The large appearance of the arms does not cause a big problem in men, and sometimes it is especially desirable. On the other hand, for women, this is a serious aesthetic disadvantage. For this reason, the majority of patients undergoing this surgery are women. In recent years, a huge amount of weight loss can occur with bariatric stomach surgeries which are frequently used. In such cases, sagging in the arms becomes inevitable and treatment may be required for both men and women.
Appropriate Patient Selection
Arm lift surgery is not life-threatening. On the other hand, it is not a simple operation. Depending on the person doing it and the patient, it may take up to 5 hours. It is not a mandatory surgery. Therefore, it is essential to examine the patient’s health status. In cases of high blood pressure, diabetes, heart, liver, kidney disease and other diseases, surgery can be performed by looking at the patient’s laboratory findings and general condition. In these cases, it is useful to get approval from the physician(s) treating the patient and then to perform the surgery.
Treatment
The treatment of sagging skin on the arms is surgery. Non surgical skin tightening treatments used on the face are not enough for the arm skin.
Young Patients With Low Sagging
The biggest reason for the arm to look thick in these people is fat accumulation. When these fats are removed with liposuction, the loose skin can recover a little and there may be some improvement in sagging. It may not be necessary to remove the skin with any incision.
Young and Old Patients With Severe Sagging
In these cases, the excess skin must be cut and removed. Even if liposuction is performed in the elderly, since the skin does not have elasticity, skin retraction does not occur and excess skin must be removed. However, this excision is limited. Because when more than necessary skin is removed, it may not be possible to close the defect and an open wound may result. Usually, an elliptical piece of skin, with its long axis parallel to the arm, is removed along with all of the adipose tissue under it. If the patient has only sagging skin and no excess fat, this procedure is sufficient. But, if there is excess fat in the other parts of the arm, outside the operation area, liposuction may be required.
Location and Length of the Incision
Since the most easily concealed area is the armpit, the incision starts here and extends along the inside of the arm towards the elbow. The incision is made on the inside of the arm because this area is relatively inconspicuous while standing. However, when the patient raises his arm, it is not possible to hide any scar here. In cases with mild sagging, the incision can be terminated on the upper arm without approaching the middle. However, in severe sagging, this incision, that is, the long axis of the ellipse, should be extended up to the elbow.
Shape of the Final Scar
When the elliptical open wound inside of the arm is closed, a straight line scar remains. However, straight line scars tend to be hypertrophied and enlarge more. For this reason, it can be arranged to leave an S-shaped or Z-shaped scar while closing the wound. Disadvantage of this type of closure is that the width of the scar is wider than the flat closure.
Surgical Technique
The surgery is usually performed under general anesthesia. The arms are opened to both sides to form an angle of 90 degrees with the body. The skin that needs to be removed is marked previously, is removed and the resulting open wound is properly closed. Rarely, before closing the wound, a thin tube called a “surgical drain” can be inserted to remove any blood that may collect under it. One end of the tube is pulled out of the skin and a negative pressure plastic container is attached to the end to absorb the blood. Protective tapes called steri-strip are adhered to the suture lines. Elastic bandages are also wrapped around the entire arm to minimize swelling.
Postoperative Care
After the operation, the patient stays in the recovery room and after feeling well is taken to the standard hospital room. If there is no nausea and vomiting, 2-3 hours later food is given by mouth. If there are no other problems, the patient is encouraged to walk. Some patients that feel completely well and do not have nausea, vomiting, dizziness, bleeding from the wound or excessive pain can be sent home 5-6 hours after the surgery. Most patients spend the first night in the hospital and the next morning, after being seen, are sent home . If a drain is placed, the amount of blood coming into it is checked and if it is not too much, it is removed. If more than expected volume of blood comes from the drain, the patient is sent home with the drain and called for control the next day. No special procedure is required for postoperative wound care. The patient can take a bath and wash the operation area two days after the operation. However, care should be taken that this area is not irritated, that is, washing and drying should be done without irritation. Bed rest is never recommended for patients. It is recommended that they may do every activity they can do without difficulty, at home. Pain and swelling (edema) significantly reduce after a week.
Complications (Problems and Setbacks)
Complications that appear in every surgery are also valid for this surgery. To summarize
Infection (Inflammation of the Wound)
No matter how much attention is paid, infection can be seen in the operation area. This usually occurs 4-5 days after surgery. With appropriate treatment, it is expected to heal in a few weeks. If it is not very serious, it does not leave an additional scar.
Bleeding or Accumulation of Blood (Hematoma)
Rarely, blood may leak unexpectedly from the surgical sites, or blood may be collected under the sutures, enough to cause visible swelling. In this case, it may be necessary to open the wound as soon as possible, find the bleeding site and stop the bleeding or drain the accumulated blood. If it is treated on time, it will not have a negative effect on wound healing.
Gangrene at Wound Edges (Necrosis)
It usually occurs due to the lack of blood flow to this area. The wound edges first turn to purple and then a black crust. In a small area, it heals with dressing changes by time, but it results in a wider scar. In a large area, additional surgeries may be required for recovery. This condition usually occurs in smokers.
Ugly Appearance of the Scar
If a region is cut and re-sutured, a scar remains in all surgeries. This reality is expected not to happen in aesthetic surgeries, but this is not valid in arm lift surgery. The more the arm is lifted, the better the result, but the greater the remaining scar. With very little stretching, few scars are left, but the result is not very pleasing. Therefore, it is essential to maintain a balance in the amount of stretching. The amount of remaining scar is also varies from person to person. In some bodies, the scars heal by hypertrophy, redness and widening. It is not possible to know this beforehand. For very noticeable scars, scar-reducing treatments can be applied afterwards. Patients should never be given hope that there will be no scars after the operation.
Patient Satisfaction with the Results
No surgery gives miraculous results, and every surgery has a price, the body has to pay. Arm lift surgery effectively narrows the arm, but ultimately leaves a scar that cannot be hidden. Patients who decide to have this surgery should accept this scar. The younger the patient is, the more obvious the scar will be. In advanced ages, the scars are relatively mild or thin.
As a result, arm lift is an effective operation when performed in experienced hands, but the patient should be informed about the amount of scar that will remain and should make a decision accordingly.
