Liposuction of the arms

Liposuction of arms when properly performed with realistic expectations is almost always a "patient pleaser." Patients routinely marvel at the degree of skin contraction that typically occurs. Before and after photos, even as early as 1 week, routinely show dramatic skin contraction when significant volumes of fat are removed although textural changes may evolve for weeks to months (Figs. 14-19). Only the lower abdomen and neck consistently obtain such profound and predictable contraction. I am convinced that historically liposuction of the arms has been performed in a substandard fashion. Inadequate fat removal will often produce irregularity and will always result in less than maximal skin contraction. As I have performed progressively larger-volume cases, the indications for brachioplasty, in my opinion, are nearly nonexistent. My present approach, except in the most extreme cases, is to initially recommend liposuction and possibly even a second liposuction prior to performing or recommending brachioplasty. Even massive arms with good skin tone will usually obtain an aesthetically pleasing result when treated properly. Massive arms with poor skin tone, however, may not. One does not "burn bridges," however, by performing liposuction alone in these questionable candidates. If brachioplasty is subsequently desirable, in spite of the major drawback of the resultant scar, it can be performed at a later date. In summary, the key concepts for maximizing the potential of liposuction of the arms are to perform thorough but gentle fat removal and to avoid immediate subdermal fat removal or trauma to the underside of the dermis.