 |
Rejuvenation of the Upper Arm
in Bethesda Maryland - Washington DC Metro Area
The surgical rejuvenation of the upper arm remains a persistent problem for both the patient and the surgeon, despite the many techniques that have been proposed for its improvement. Upper arm changes that occur with age have been studied extensively.1 Glanz and Gonzalez-Ulloa demonstrated the progression with age of the inferior curve of the upper arm and the loss of support structures that result in the obvious ptosis of “bat wing” appearance. Traditionally, these problems have been corrected with the reduction of skin and subcutaneous fat. Brachioplasty was first introduced in 1954 by Correa-Iturraspe and Fernandez.2 Since then, the procedure has undergone a series of modifications to improve the appearance of the scar and the resulting contour of the arm. These include techniques such as Z-plasties, W-plasties,3 curving S-incisions,4 quadrangular flaps and T closure,5 deepithelialized rolled-up flaps,6 and fascial system suspensions.7 The focus of the modifications has mainly been to improve on the poor aesthetic result of scar sequelae such as retractility, healing, and widening of the scar.8 With the advent of suction lipectomy, removal of excess fat can be accomplished easily with minimal scarring and fewer complications. However, the problem of newly created or preexisting skin ptosis remains.
Many patients seeking reduction of their upper arms are concerned with the laxity of skin, muscle mass loss, and fat deposits. In general, they feel their arms seem to be out of proportion to the rest of their body. In addition to the older patients, those who have undergone major weight loss (either after dieting of after a gastric bypass procedure) are likely to focus on the flabby bulges that droop when they raise their arms. We propose a general classification of these patients by the degree of severity and with a corresponding surgical treatment that will provide the best aesthetic result. New techniques in the rejuvenation of the upper arm are also presented.
If you are interested in scheduling a complimentary consultation for breast enlargement or breast augmentation surgery, please use our online plastic surgery information form to make an appiontment.
1 Glanz, S., and Gonzalez-Ulloa, M. Aesthetic surgery of the arm: Part I. Aesthetic Plact. Surg. 5: 1, 1981.
2 Correa-Iturraspe, M., and Fernandez, J.C. Dermolipectomia braquial. Prensa Med. Argent. 41: 2432, 1954.
3 Borges, A.F. W-plastic dermolipectomy to correct “bat-wing” deformity. Ann. Plast. Surg. 9: 498, 1982.
4 Pitanguy, I. Correction of lipodystrophy of the lateral thoracic aspect and inner side of the arm and elbow dermosenescence. Clin. Plast. Surg. 2: 477, 1975.
5 Juri, J., Juri, C., and Elias, J.C. Arm dermolipectomy with a quadrangular flap and “T” closure. Plast. Reconstr. Surg. 64: 521, 1979.
6 Goddio, A.-S. A new technique for brachioplasty. Plast. Reconstr. Surg. 84: 85, 1988.
7 Lockwood, T. Brachioplasty with superficial fascial system suspension. Plast. Reconstr. Surg. 96: 912, 1995.