Arm Lifting With Subdermal Axillar Brachioplasty

Traditional brachioplasty for moderate to severe arm laxity typically requires longitudinal incisions extending from the axilla to the elbow, often resulting in visible scarring and patient dissatisfaction. To address this limitation, we developed subdermal axillar brachioplasty (SAB), a minimally invasive technique combining liposuction, gas-assisted subdermal radiofrequency, and limited axillary skin excision.

A retrospective observational cohort study was conducted including 67 female patients who underwent SAB between January 2023 and November 2025. Patients with Iglesias grade IV laxity and active smokers were excluded. Arm laxity was objectively measured using a standardized metric protocol preoperatively and at 12-month follow-up according to the Iglesias classification. Outcomes included postoperative laxity grade, surgical parameters, complications, and patient satisfaction assessed using the BODY-Q scale.

Preoperatively, 73.13% of patients presented with grade III laxity and 26.86% with grade II. At 12 months, 89.55% achieved grade I laxity and 10.44%, grade II. The mean lipoaspirate volume was 245 ± 62 mL per arm, reflecting conservative contouring. Mean axillary incision length was 5.4 ± 0.4 cm. Complications included 2 hematomas (2.98%), 1 seroma (1.49%), and 1 infection (1.49%). BODY-Q scores significantly improved from 31.9 ± 2.98 preoperatively to 94.2 ± 3.45 postoperatively (P < 0.001).

SAB is a safe and effective technique for patients with moderate arm laxity, achieving significant contour improvement and high patient satisfaction with minimal visible scarring. This approach offers a viable alternative to traditional longitudinal brachioplasty in appropriately selected patients.