Arm Lift Surgery (Brachioplasty) Cost and Information

An arm lift aims to reduce excess skin and fat in the upper arms and create a more aesthetically pleasing arm shape. It also aims to tighten and smoothen the underlying supportive tissue, providing a more defined shape to the upper arm. During your consultation, the surgeon will discuss what contributes to the overall shape of the upper arm. It can be excess fat alone, excess skin alone (usually in patients post massive weight loss), or a combination of both.

If there is mild-moderate skin excess, patients may benefit from liposuction alone and the use of radiofrequency devices to help with skin tightening. If there is a mild-moderate skin excess, a mini-brachioplasty can be performed after liposuction – this involves a small horizontal incision in the armpit. This is suitable for patients with mild to moderate skin excess but also for patients not willing to undergo the larger incision required for a full brachioplasty.

Patients with significant skin and fat excess would require a combination of liposuction and a full brachioplasty – this involves a scar from the armpit to the elbow.

Patients may choose to have an arm lift if they have:

• Excess skin after major weight loss
• Drooping skin as a result of ageing or heredity
• Excess fat deposits and cellulite

Arm lift surgery will typically cost between £5,000 and £6,000. Like any procedure, there are some variables that will affect the final price; they include:

• Surgeon experience
• Anaesthetist experience
• The complexity of the individual procedure
• Surgical techniques (whether it is a revision surgery or Rib Graft, for example)
• The time required in surgery for each patient’s case

A final price is offered after the consultation with the surgeon. In the consultation, all expectations and details are discussed and agreed upon based on a patient’s individual wants and needs and the surgeon’s expert advice.

Once a final price has been offered, it will cover the following:

• Surgeon and anaesthetist costs
• Hospital costs
• Overnight stays (if required)
• Aftercare and follow-up appointments

It is an increasingly popular procedure and is in high demand, especially among those who have lost large amounts of weight.

Who are the ideal candidates for an arm lift?

For various reasons, arm lift surgery is not suitable for everyone. Those who would be considered the ideal arm lift candidates include individuals who are:

• At a stable weight and have a BMI of less than 30 – 32
• Struggling with excess skin in their upper arms as a result of weight loss, ageing or genetics
• Willing to continue a healthy lifestyle after surgery
• Non-smokers or are smoke and nicotine-free for at least six weeks before the procedure
• Realistic with their expectations
• Emotionally ready for surgery

Why have arm lift surgery?

The upper arms tend to droop down and sag after significant weight loss, ageing or due to genetics. This can make some people feel very self-conscious and unable to wear clothing that exposes their upper arms. People often find that this excess skin is difficult to lose through exercise and a healthy diet alone and, therefore, choose to have an arm lift to correct it.

An arm lift can:

• Re-define the upper arm by tightening and smoothing the underlying tissue
• Remove excess drooping skin after significant weight loss
• Remove small pockets of fat in the upper arm
• Boost self-esteem
• Create more youthful-appearing arms that better complement the rest of the body.

Despite this, it is important to be aware that arm lift surgery is not a method to be used for weight loss. It is only for people who have tried to reach their optimal weight and, as a result, have excess skin or stubborn fat.

When considering an arm lift procedure, it is advised that you make efforts to optimise your health. Therefore, doing regular exercise, reducing alcohol intake, maintaining a healthy diet and stopping smoking will improve suitability for surgery.

How is an arm lift procedure performed?

The arm lift procedure usually takes between 90 to 120 minutes. It is most commonly performed as a day case, but an overnight stay in the hospital can be arranged if a patient prefers. Before patients go in for an arm lift, they must follow the surgeon’s instructions for eating, drinking and taking medications the night before surgery. Patients must follow this guidance or the surgeon.

An arm lift surgery involves the following steps:

Consent form

Patients will have to sign a consent form before having surgery. This is often in a consultation before the day of the operation. On the day of surgery, the surgeon will draw some lines on the arms and rediscuss the goals of the arm lift. Photos may be taken if not taken during the consultations.

Anaesthesia

The anaesthetist will then give an anaesthetic. For an arm lift, patients can either have a general anaesthetic or local anaesthetic with IV (intravenous) sedation. The type of anaesthetic patients are given will depend on the surgeon’s practice. The patient and the surgeon will discuss which anaesthetic to use during the first consultation.

Incisions

After the anaesthetist gives the anaesthetic, the surgeon will clean and put drapes over the surgical area before making the incisions. The incisions for a Brachioplasty can either be made in the armpit or along the back of the arm. These positions allow the surgeon to conceal these scars well. There are three types of incisions that surgeons can use:

Mini Brachioplasty (minimal incision)

For a mini Brachioplasty, the surgeon will make a single incision in the shape of a crescent under the armpit. The surgeon may, however, extend the incision into the arm. This is a T-line lift.

This technique is most suitable for people with minimal excess skin and fat in the uppermost region of the arm.

A mini Brachioplasty results in a smaller amount of scarring than a standard Brachioplasty. The surgeon will hide the scar well within the armpit. However, the results are only effective in patients with minimal excess skin and fat.

Standard Brachioplasty (inner arm incision)

This technique involves removing skin as an ellipse; the resulting scar from the closure of the ellipse is planned to be in the back of the arm or hidden on the inside of the upper arm. The incision would extend from the armpit to just above the elbow. In some patients, especially after massive weight loss, the incision needs to be extended beyond the elbow.

It is most suitable for those with a moderate to significant amount of excess skin and fat. The surgeon will remove the excess skin and fat and then tighten and reshape the underlying tissues. The scar is well hidden when the arms are held at the side, and this technique is thought to achieve a better result in contouring the upper arm.

Extended Brachioplasty

The incision for an extensive brachioplasty runs from the elbow, through the armpit, and into the side of the chest.

After the surgeon makes the incision, they will remove excess skin and fat and then tighten the underlying tissues. They will either remove the excess fat directly or use liposuction to remove it.

As this technique results in maximal scarring that extends to the side of the chest, surgeons do not often use it.

The surgeon will discuss the different techniques and suggest which one will achieve the best results for the patient's body. The BAPRAS/BAAPS surgeon’s choice will depend on several factors, including the amount of excess skin and fat in the upper arms.

Closing the incisions

The surgeon will close the incisions using stitches. In most cases, all the stitches used are internal and dissolvable in nature. They will then wrap a bandage around the upper arms. A compression garment is usually used and can be worn for up to 3 months after the surgery. Patients may also have some small drainage tubes put under the skin to help drain any fluid. Usually, the drains are removed before the patient is discharged to go home.

Return to the ward.

After the arm lift procedure, patients are taken to the ward to recover from the anaesthetic. They will be able to go home on the same day, but occasionally, they may have to spend one night in the hospital following the procedure. Patients should be able to go home to rest the next day.

What to expect during an arm lift consultation?

The arm lift consultation will usually last between 15 minutes to an hour. During this consultation, the surgeon will discuss all aspects of the operation. Many surgeons will want to see you at least twice for a consultation prior to any procedure. There are some important topics that they will cover. These include:

• Why the patient wants to have an arm lift
• Their expectations and desires
• Advice on how to achieve the best results
• The risks and complications of the procedure

After discussing the details of the arm lift. The surgeon will ask about the patient's medical history:

• Current health status
• Past or current medical conditions
• Medications, including herbal remedies and vitamins
• Use of alcohol, tobacco or recreational drugs
• Drug allergies
• Previous surgeries.

The surgeon will also examine the upper arms and take photos of them for medical records. They will then present their options to the patient. The surgeon will base these options on:

• The best surgical approach to the problem you have expressed
• The amount of excess skin and fat you have
• The elasticity of your skin.

Questions to ask during the arm lift consultation

It is imperative that patients fully understand the procedure. This consultation provides patients with the opportunity to discuss any feelings they have about the surgery and ask any questions they may have, such as:

• Do you think that what I want to achieve from surgery is realistic?
• What will you expect from me to get the best results?
• How will you perform my procedure?
• Where will my scars be located?
• How long will the recovery period be, and what kind of help will I need in this period?
• Have you performed this surgery before?
• Is it possible to see photos of similar operations you have done?

What are the main risks & complications?

Before patients consent to having surgery, it is important that they consider the arm lift risks and complications. Surgeons typically recommend that patients take two weeks after the initial consultation to think about all aspects of an arm lift procedure before having a second consultation to answer any further queries and confirm the surgical plan. The risks include the following:

Seroma

A seroma is a pocket of fluid that collects under the skin. This pocket often develops under or around the area where the incision is made. Although not very harmful, if a seroma becomes too large, the surgeon may have to drain the excess fluid using a needle and syringe.

Scarring

As an arm lift requires the surgeon to make surgical incisions, patients will be left with a scar. The incision lines for this procedure are purposely put in places that are as discreet as possible. If scarring is a particular issue, patients may consider having the mini Brachioplasty, which produces the least amount of scarring. However, it is not suitable for all patients.

Patients should also be aware that there may also be some asymmetry in the scars between the two arms, but the surgeon will do their best to reduce this.

Some patients experience more severe forms of scarring called keloid or hypertrophic scars. It is important to notify the surgeon if patients have had this type of scarring in the past.

Swelling and bruising

After an arm lift, there may be a large amount of swelling and bruising in the arms. The skin area around the wound may appear darker or lighter in colour. Patients may also find that they experience some swelling of the hands. This should all resolve over time, typically within two to three weeks.

Infection

Patients must take any infection seriously if it occurs. In most cases, the infections are only mild wound infections that the surgeon can treat with some antibiotics. If a more serious infection occurs, they may need to go back to the hospital for treatment. Patients must flag up any signs of infection, which can include:

• Any fluid or pus coming out of the incision
• An increasing amount of pain that is not relieved by medication
• Foul-smelling discharge
• A temperature greater than 38°C
• Redness or swelling that is starting to spread away from the incision line.

General surgical complications

All surgical procedures carry some common risks. These include, but are not limited to:

• Blood clot formation
• Vomiting and nausea
• Blood loss
• Infection
• Problems with anaesthesia.

The surgeon will discuss all of the possible risks prior to the surgery. It is also important that patients follow the surgeon’s pre and postoperative advice to further reduce the chance of these complications occurring.

If patients experience any periods of sudden shortness of breath, unusual heartbeats, chest pain or a red swollen arm that is very tender to touch, it is essential patients contact the surgeon immediately.

Aesthetic

Patients must keep in mind that they may be unhappy with the aesthetic results of the surgery. To try and avoid this happening, patients are advised to choose their surgeon carefully and make sure that they fully understand all expectations and desires.

Fat, tissue or skin necrosis

During an arm lift procedure, areas around the surgical incision might lose their blood supply. If this happens, the area that is affected may die. This is a very rare complication and is called necrosis. It can happen in the fat, tissue or skin of the arms. The necrosis makes the area under the skin firm and uneven in appearance. Patients may need further surgery to remove these areas if they do develop. The risk of this happening increases if patients are a smoker. This is one reason why patients must be smoke and nicotine-free for at least six weeks before and after the arm lift.

Changes in skin sensation

As the surgeon repositions and tightens the arm tissues, it may cause some damage to the sensory nerves around that area. This can lead to changes in the feeling or sensation in the arms. Patients may experience either increased sensation, a decrease in sensation or strange feelings of burning or tingling. In most cases, however, this should resolve itself within a few months after the procedure. Rarely these changes in sensation can become permanent.

Sutures

After the procedure, the surgeon will close the incisions with either absorbable or non-absorbable sutures. There is a risk that these may irritate, poke through the skin or become visible. If this happens, the surgeon will remove them.

Bleeding

It is common to experience some minor bleeding after the operation. Bleeding can, however, become more severe. This tends to happen immediately after the operation but can occasionally occur up to 2 weeks later. Patients may need to have surgery to correct this.

Choosing a highly qualified BAAPS/BAPRAS surgeon will decrease the chances of developing any of these arm lift risks and complications.

How to prepare for an arm lift?

Patients should prepare well before having arm lift surgery. The surgeon will give specific advice on what to do prior to having the procedure. Here are some guidelines patients have found useful

Medication

You may be advised to stop Aspirin, Ibuprofen or other NSAID products (i.e. Nurofen, Advil, Aleve, Motrin) for up to a month before and after cosmetic procedures. It is vital you check with your surgeon before taking any of these medications. You may also be advised to stop taking other regular prescription medications (such as the contraceptive pill) as they can increase the risk of complications.

Please note that some homoeopathic medications are associated with complications such as postoperative bleeding, so will likely need to be stopped. Preparations include (but are not limited to) those containing ginger, ginkgo, cod liver oil, St Johns Wort, and several multivitamin preparations. Be sure to ask your surgeon for advice on drinking alcohol with prescribed medication.

Sleep

Patients may find that after surgery, it may be more comfortable to prop themselves up while they sleep. Patients can do this by having loads of extra pillows on their bed.

Household items and chores

Patients should try not to strain the incisions on the arms by reaching up for cupboard items. Patients might, therefore, find it useful to put cupboard items such as mugs, crockery, and dry food on the kitchen counter. This stops them from having to reach to get items. It may be useful to clean the house, do the washing and take the bins out before the operation takes place. This gives patients more time to recover.

Grocery shopping

As patients will not be able to lift any heavy items for a while after the procedure, they should do a big food shop shortly before the arm lift surgery. Patients could also prepare some meals to put in the freezer so that they do not have to worry about cooking.

Children & pets

As patients will need plenty of time to rest and recover, patients should ask family and friends to help look after children and pets for the first week or so after the operation.

Driving

Patients will not be able to drive straight after the operation. They should, therefore, ask a family member or friend if they can take them home or are able to arrange transport.

Diet

Maintaining a healthy diet will help patients recover. Try to have lots of protein, fruits, vegetables, and water.

Clothing

Be sure to have some comfortable, loose-fitting clothes to wear after the procedure. It is advised to wear tops that can easily fasten from the front to avoid straining the incisions.

What to expect after an arm lift?

The BAAPS/BAPRAS surgeon will give specific instructions for the arm lift aftercare process. This will include timeframes for when patients can expect to go back to work, exercise and drive. Before patients are sent home, a post-operative appointment will be arranged. During this appointment, the surgeon will remove any non-absorbable stitches, examine the arms and see any complications that may have arisen.

First 24 hours

The treated area may be bruised and swollen post-operatively, and you may experience a feeling of “tightness” in your arms or thighs. This should subside over the next 2 to 5 weeks.

Compression garment

After the arm lift, patients will need to wear a tight bandage called a compression garment around the upper part of the arms. They will need to wear this for 4 to 8 weeks, depending on the surgeon’s advice. This garment helps reduce swelling and, therefore, helps to achieve a better result.

Bathing and showering

To promote good healing, keep your incisions clean and dry and inspect them regularly. Your surgeon will advise you when you can shower and bath again after your surgery. The usual advice is to sponge bath only for the first 48-72 hours after surgery. When you start showering again, and your incisions are undressed, wash them gently with soap and water.

Ask your surgeon when you can use:

• Bathtubs
• Saunas
• Swimming pools

Do not remove any dressings unless instructed by your surgeon - these will be removed within one week at your post-operative appointment.

Self-care

After your procedure, it is important you follow the aftercare instructions given by your surgeon. This will include information about wearing your compression garment, caring for your drains (if applicable), and taking any medications that may be prescribed.

To prevent blood clots, it is recommended you start light walking again as soon as possible. When you rest, lie on your back with your arms or legs slightly elevated on pillows to help reduce swelling.

To prevent swelling and promote good healing, try to avoid:

• scratching - although some itching of the healing wounds is expected
• exposing scars to the sun (for at least 12 months), it is important to apply sunscreen of 50 SPF when the scars are exposed to the sun
• smoking and nicotine products (including nicotine gum)
• for six weeks to 3 months pre and post-op
• applying warm compresses (they can increase swelling)

Scar-care

The surgeon may suggest some methods that can help reduce the appearance of your scars. These may include:

• Scar massage

Massaging your scar after the incision heals may aid the healing process.

• Silicone sheets, gels or creams

Using silicone gels, creams, or sheets has been clinically proven to help reduce the appearance of scars. If the surgeon advises patients to use silicone products, it is important to follow their instructions on using them.

• Avoid sunlight & sunbeds.

It is important not to expose the scars to direct sunlight. Sunlight not only darkens the scar but can also cause damage to the healing skin and increase the risk of developing skin cancer in that area.

Returning to work

How quickly patients can return to work after the arm lift depends on the type of job a patient holds. If patients have an office job, they may only need 1 to 3 weeks off. If, however, the job involves physical activity such as waitressing or childcare, patients may need to take 3 to 4 weeks off.

Despite the job they have, patients should be able to resume their daily routine after two weeks – as long as this does not involve rigorous activity.

Returning to exercise and sport

Weeks 1 to 2

For the first two weeks, patients should not do any exercise or sport. Any physical activity such as these may increase swelling and negatively affect their final results. Patients should also avoid sexual activity for two weeks.

Weeks 2 to 6

After two weeks, patients may begin to do some sports that do not involve very vigorous movements, like cycling, for example. Patients will still not be able to lift any heavy weights or partake in any contact sports.

After six weeks

Six weeks after the arm lift, patients should be able to resume all types of sports and exercises again.

Driving

Depending on the surgeon's advice, patients may not be able to drive for between 5 days to 2 weeks after surgery. Patients should, therefore, make sure that they have a family member or friend to help with travel during this time period.

When to seek urgent help

If following an arm lift, you experience any of the following, seek urgent help:

• Increased swelling, bruising, or bleeding.
• Persistent redness or pain around the operated area.
• Severe or increased pain not relieved by medication.
• Discharge, especially foul-smelling discharge from the area of incision.
• Significant bleeding at the incision sites.
• Blood clot signs: breathlessness, chest pain or swelling and pain in the calf.
• Pain relief medication side effects: rash, persistent vomiting, dizziness, fainting, headache, breathlessness or shallow breathing.

Final results

It may take some time before patients can see the final results of the arm lift surgery. Patients should expect to see some bruising and swelling for at least the first 2 to 3 weeks. 6 to 8 weeks after the procedure; they should be able to start seeing the full results of the arm lift. However, it can take 6 to 9 months before everything completely settles.

Patients are advised to follow the surgeon’s personalised arm lift aftercare instructions to ensure that they get the best results possible.

An arm lift is not a suitable procedure for everyone. In some cases, it is strongly advised that you do not have an arm lift. It is not recommended if you have had:

• A complete mastectomy (removal of the breast) after breast cancer
• Surgery on the armpit or lymph nodes under the arms.

These procedures affect the drainage of the upper arm and, therefore can cause post-operative swelling to persist and increase the risk of complications.

After an arm lift, you may have a small plastic tube placed under your skin at the site of the incision. This ensures any blood or fluid that may build up during the operation can freely drain, therefore avoiding build-up. You will generally only have the drains kept in for 1 to 2 days. If you do have drains put in, your nurse will give you advice on how to take care of them.

Your surgeon will be happy to see you without a GP referral. They will, however, contact your GP to get a full list of your medical history before you have surgery. There may also be certain medical conditions that require a GP to sign off before you're able to have the arm lift procedure. Your Patient Care Adviser will let you know if this applies to you.

If you smoke, drink alcohol, are overweight or take drugs for medical or other reasons, the risks of surgery are greatly increased. Smoking in particular delays the time it takes for your wounds to heal, and increases the risk of infection. For this reason, our surgeons recommend that patients stop smoking and using all nicotine products at least 6 weeks before and after arm lift surgery.

Any major changes in weight can impact the final results of your arm lift. Major weight gain will re-stretch the arms to their former position. Major weight loss will cause a return of excess upper arm skin. We, therefore, advise that you reach a stable weight before having an arm lift.

All of the information found on our website is sourced from highly reputable experts, government-approved authorities and is widely used by healthcare professionals.

• https://www.americanboardcosmeticsurgery.org/procedure-learning-center/body-procedures/skin-removal-after-weight-loss/ American Board of Cosmetic Surgery
• https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/brachioplasty John Hopkins Medicine
• https://www.plasticsurgery.org/cosmetic-procedures/arm-lift American Society of Plastic Surgery

Our content is written by our Medical Quality Managers and Patient Care Advisers, all of who have medical backgrounds and training. Prior to publishing, all the information is reviewed by a surgeon specialised within the relevant field.