Wednesday, November 24, 2010

L-Brachioplasty – an Article Review

 Updated 3/2017-- photos and all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

With the increase number of patients receiving weight-loss surgery, there is has been an increase in those asking for procedures to remove the remaining excess skin such as panniculectomy, abdominoplasty, lower body lift, brachioplasty (arm lifts), and thigh lifts.
The scars involved in brachioplasty surgery are not a good trade-off if there is minimal skin excess or looseness.  These individuals are better served by upper arm exercises to increase the muscle mass.
Brachioplasty (arm lift) is defined as the removal of excess skin and subcutaneous tissue to reshape the upper arm (axilla to elbow). (photo credit)
The L-brachioplasty described in the Hurwitz article from the July/August 2010 issue of the Aesthetic Surgery Journal addresses significant excess upper arm skin and the excess which often extends to the chest wall lateral to the breasts (photo credit).
The article very clearly described the procedure from the beginning to middle to end to postoperatively.  If you do brachioplasty surgeries, it is an article worth reading.
The operative time for each arm is approximately 40 minutes. The incisions are covered with sponge dressing and then wrapped in ACE bandages (BD, Franklin Lakes, New Jersey) with the hands elevated. The sponges and bandages are removed and replaced with tightly fitting elastic sleeves five days postoperatively.
Hurwitz mentions 13 women and two men were treated over the past four years using this procedure.  Complications included one seroma (treated by aspirated on one occasion) and incision dehiscence limited to less than 1 cm in five patients.  No patients had contractures across the axilla. 
Most insurance companies (as with Aetna and Cigna) consider brachioplasty surgery a cosmetic procedure.

L-Brachioplasty: An Adaptable Technique for Moderate to Severe Excess Skin and Fat of the Arms; Hurwitz, Dennis J., Jerrod, Keith; Aesthetic Surgery Journal, July/August 2010 30: 620-629;  doi:10.1177/1090820X10380857
Lockwood T. Brachioplasty with superficial fascial system suspension. Plast Reconstr Surg. Sep 1995;96(4):912-20.
Arm Lift Photo Gallery from Sean Younai, MD, FACS

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