Arm Lift (Brachioplasty) Sydney North Shore

Cosmetic Concerns Procedure Information Risks & Complications FAQs Pricing

An arm lift (brachioplasty) involves the excision of loose skin and fat from the arm – from the area of the armpit to the region of the elbow. This is sometimes referred to as correction of ‘bingo arms’ or ‘bat wings’.

A limited brachioplasty involves a scar just in the region of the armpit and can be effective in mild cases of loose skin and fat.
On the other hand in more extreme cases, the scar can extend on to the side of the chest to remove excess skin and fat in this region.
The aim is to reduce the circumference of the arm, which produces a slimmer, contoured shape to the arm.

This procedure is suitable for men and women who have lost a large amount of weight which could be either through diet and exercise or through bariatric surgery. The loose amount of skin and fat often interferes with their daily life, and exacerbates skin rashes and other skin conditions.

Men and women seek arm lift surgery to

Wear clothes that may otherwise reveal the loose skin or excess fat they find embarrassing
Wear swimwear they want to wear
Feel confident in social situations
Restore shape of their arms after going through massive weight loss
Remove skin and fat that cannot be addressed through other means
Improve skin rashes and conditions that are exacerbated by the loose skin and do not improve through other means

The best candidates for an arm lift are men and women who:

Have already lost the weight they want to lose
Have been a stable weight for at least 6 months (ideally 12 months)
Are physically and mentally healthy
Have realistic expectations
Are willing to accept the long and visible scar of an arm lift

An arm lift may not be suitable for those who:

Have not lost the weight they want to lose or have significant fluctuations in their weight
Are very overweight or obese (BMI >35) – ideally your BMI should be less than 30 for best results.
Have lymphoedema of the arm
Have a neurological or vascular disorder affecting the arm
Have multiple medical problems
Are on blood thinning medication
Are actively smoking
Will not accept the long visible scar of an arm lift

Those who can accept the trade-off of large scars for excision of skin and fat, can achieve remarkable outcomes from arm lift surgery.

Patients who lose massive amounts of weight may consider other surgeries:

Women may consider Breast Surgery
- Breast Augmentation
- Breast lift/Reduction
- Augmentation-Mastopexy
Lower Body Lift
Upper body lift
Thigh lift
Liposuction
Face and neck lift.

For more information on other procedures please read the other sections of this website.

Dr Aggarwal

Dr Aggarwal is a well regarded, respected, highly skilled and experienced Specialist Plastic Surgeon. Graduating at the top of his class throughout his training, Dr Aggarwal has completed fellowship training at some of the world’s most prestigious reconstructive and cosmetic plastic surgery institutions in Canada and the USA. He continues to publish research is prestigious plastic surgery journals, and is actively involved in the training of future plastic surgeons.

What sets Dr Aggarwal apart from others is his personal, affable and warm nature. Not only does he pay attention to detail, to producing natural, beautiful results but he ensures that the patient’s journey is just as special as their outcome. Dr Aggarwal looks after patients at one of Sydney’s most prestigious public hospital campuses (POWH/SCH/RHW), and operates privately on Sydney’s North Shore. Dr Aggarwal has treated thousands of patients throughout Sydney and beyond who have achieved outstanding results under his care.

Procedure Snapshot

Anaesthetic: GA by accredited anaesthetist
Time: 3 hours (1.5 hours per side)
Duration of stay: 2-3 night stay in hospital *can be longer
Hospital: At any of the private hospitals where Dr Aggarwal works.
Medicare/Health fund rebate: Yes for those who meet the following criteria (introduced in 2016):
- Significant loss of weight equal to or greater than 5 BMI points
- Skin condition exacerbated by loose skin and fat
- Skin condition not resolving with 3 months of conservative therapy

In addition you need to have the appropriate level of health fund cover.
Recovery: Most people stay in hospital for 2-3 nights, largely due to drains. This also depends on what other surgery has been performed. Heavy lifting or exercise is disallowed for 8 weeks and strenuous exercise for 3 months. For 8 weeks you will be required to wear a compression garment for the arm. You can shower once the drains have been removed and have to avoid swimming until all wounds have healed (at least 2-3 weeks but it can be longer).
Results: Can be a life changing operation and a massive reward for patients who have done well to lose massive amounts of weight.

Cosmetic Concerns

I don’t mind the scars but want to have as much skin and fat excised.

This is a good mindset to have after undergoing massive weight loss, and it these patients who will do well from arm lift surgery.
The scar from an arm lift traditionally extends from the arm pit down to the elbow but sometimes can also extend on to the side of the chest.
This area can be visible especially in short sleeve clothing.
The quality of the scar is not always great in this area, so this has to be kept in mind before opting for surgery.
However the reduction of skin and fat from the arm and therefore the reduced arm circumference can be dramatic.

“I have lymphoedema of the arm as I had lymph nodes removed from the arm pit– can this be fixed”

This means you should not have an arm lift as this is a contraindication to surgery.
Lymphoedema of the arm is a difficult problem to fix – it is managed by compression and massage on a day to day basis.
There is some evidence that a vascularised lymph node transfer to the arm pit can have good results in lymphoedema of the arm, but this is a very different procedure to an arm lift.

“I want to have a shorter scar – is this possible?”

The decision of which scar will be employed depends on the amount of loose skin and fat.
In a limited brachioplasty the incision is significantly smaller than a conventional brachioplasty where is limited largely to the armpit. This can be a good option for those who have mild skin laxity.
However if you do have significant loose skin and fat it is better you will need a longer scar to achieve the goals you want from surgery. In these cases the shorter scar will improve some of the contour closer to the arm pit but will not achieve improvement on the loose skin closer to the elbow.

“I want to have a thigh lift at the same time”

This is certainly possible at the time of arm lift surgery.
Often our patients will have their lower body lift and chest procedures first.

“I want to have my breast surgery at the same time”

This depends on what the surgery is, but in short this is certainly possible.
However in patients who have lost a large amount of weight, have loose skin and fat around their chest, their armpit and their arms extending down to the elbow.
At Mode we suggest that these patients have their chest surgery (or breast surgery for females) and a lower body lift first. This is because some of the loose skin from the armpit and sides of the chest can be useful in shaping the chest/breast.
Any loose skin not addressed by the chest/breast procedure can be addressed at the time of the arm lift surgery performed at a later date.

Procedure Information

The procedure is performed under general anaesthesia given by an accredited anaesthetist in a fully accredited and licensed facility (usually one of the North Shore’s premier private hospitals). The procedure takes 3 hours for both sides and most patients will spend at 2-3 nights in hospital.

Preoperative nutritional assessment

Patients with massive weight loss can have nutritional deficiencies
This is especially the case in patients who have undergone bariatric surgery and have experienced rapid weight loss
You are most likely to be sent for preoperative blood tests and sometimes a nutritional assessment before undergoing lower body lift surgery

Incisions

A scar has to be placed from the arm pit all the way around to the elbow on the inside of the arm. The exact position of this scar is changed in different patients depending on the amount of loose skin and fat.

The operation usually begins with liposuction which helps decrease the circumference of the arm, allowing more skin to be removed. This step depends on the amount of fat excess in the arm.
The skin is excised carefully and closure is undertaken simultaneously.

Drains

In general 1 drain is used in each arm.
Whilst in hospital the drain outputs are recorded, and the drains removed once fluid drainage is minimal.
It is not uncommon for patients to go home with a drain and see Dr Aggarwal or his staff in rooms to have the drain removed after discharge from hospital.

After your arm lift surgery

Dr Aggarwal will place dressings over the incisions.
When you come out of surgery you will have your arms wrapped in tight compression bandaging to help with swelling.
When you walk you will need to keep your arms elevated.
You will be able to get all areas wet once the drains are removed.
Swimming in a pool or beach is usually deferred for several weeks until all incisions are healed and all the drains are out.
You will be given a script for antibiotics by Dr Aggarwal which you must continue until all drains are removed. You will also be given appropriate pain relief medications.
When you go home it is best to have someone look after you as you recover.
While most sedentary activities can be resumed when you go home, you must lay low and not exert yourself. You will also not be allowed to do any heavy lifting or exercises for the first 8 weeks. During this period you will also be required to wear a compression garment.
Dr Aggarwal will see regularly after your discharge from hospital.

Risks & Complications

Every surgery carries risks, and therefore one must consider if risks outweigh the benefits for your own personal situation. If they do then the surgery may be well worth it. Dr Aggarwal will discuss the pros and cons of surgery with you during your consultation.

General Complications

Risks of anaesthetic – there are general risks of going under an anaesthetic such as stress on the heart and lungs, risk of reaction to anaesthetic drugs and risk of clotting in the legs.
Bleeding (2-5%) – any bleeding is controlled during surgery however unexpected bleeding can occur in the immediate postoperative period. If this occurs it will necessitate a return to theatre to control the bleeding.
Infection (2-5%) – this is rare. However you are given antibiotics during induction (when you are going to sleep), as well as a course of oral antibiotics after your surgery to keep this risk to a minimum.

Specific Complications

Poor Wound Healing, wound separation (10-20%) – Risk of wound issues are much more common in arm lift due to the long scar but also the tension created by removing the skin around the cylindrical arm, and the swelling that occurs after surgery. These are more common in patients who are malnourished or have protein or other vitamin and mineral deficiencies, and in those with medical problems, diabetes and patients who smoke. Usually wound issues resolve with dressings over several weeks.
Skin necrosis – this is a rare complication but risk is higher in patients who smoke or are diabetic.
Change in arm sensation – it is common for parts of the arm and forearm to be numb after surgery. Very small nerves that are barely visible, are removed during excision of the skin from the arm. While the larger nerves are left behind they may also be traumatised during liposuction which frequently accompanies this procedure. Usually sensation returns over weeks to months, and can take up to 12 months to recover.
Asymmetrical scars – This should be regarded as the norm in arm lift surgery given that all tissues are lax and floppy. There are natural asymmetries to the body and there can be a difference in how each side of the body behaves to surgery and skin tension, and can produce an asymmetry to the scars, albeit the aim is to get them as symmetrical as possible.
Hypertrophic or poor scars – How one’s body behaves to scarring is individual and largely genetic. Some types of skin are more prone to hypertrophic or keloid scarring, and some individuals and families are more prone to this. We will routinely advise you on how to improve the quality of scars over time. You should also discuss any history of abnormal scarring with Dr Aggarwal preoperatively.

Procedure FAQs

Do I need a referral for an arm lift?

It is best to obtain a referral for arm lift surgery as it is possible to claim a Medicare rebate of approximately $73 for the consultation if you have a referral.
You should have documented in your referral the amount of weight lost, the reduction in your BMI, and skin rashes or other skin conditions that may have been exacerbated by the loose skin and fat. This is because as of 2016 there are strict criteria used by Medicare for this surgery.
A referral will therefore also allow you to claim a rebate for this procedure from Medicare/health funds, as long as you are appropriately insured.

Where can I see Dr Aggarwal?

You can see us at our main practice at Gordon, or at our other locations at Hornsby, Hunters Hill or Camperdown.
Please scroll to the bottom of the page to find out more information about these locations.

Where will I have my operation?

Any of the hospitals where Dr Aggarwal works – usually at Sydney Adventist Hospital, or Hunters Hill Private Hospital.

What can I do to prepare for surgery?

Cease fish oil, and other supplements such as Ginkgo, Ginseng.
Take protein supplements and multivitamins well in advance of your surgery, and any other supplements to correct nutritional deficiencies that may have been picked up before surgery.
Stop smoking well in advance of surgery – Dr Aggarwal does not offer arm lift surgery to patients who are actively smoking.

After surgery, will I need to wear a special surgical garment?

You will also be required to wear a compression garment for around 8 weeks.

Will I be able to exercise after surgery?

Light exercise may be allowed at 4 weeks.
Heavy lifting and exercise will need to be avoided for 8 weeks to allow the arm tissues to heal.

Will I need special medications after surgery?

Dr Aggarwal will provide you with the necessary scripts for antibiotics and pain relief. The antibiotics need to be continued until when the drains are out.

Will I need further surgery?

Not usually for the arm.
However patients who undergo massive weight loss return for other surgeries such as thigh lift, upper and lower body lift, and facial cosmetic surgery.

Can I travel in an airplane after surgery?

Yes
However we always encourage patients not to be away overseas shortly after having a procedure, so that we can closely follow your recovery and address any concerns that may arise

When will I be able to swim after an arm lift?

You may do gentle swimming in a pool or beach after 2-3 weeks once all wounds have healed and all the drains are out.

When will I be able to drive after an arm lift?

It is best to not drive for the first 2 weeks after arm lift surgery.

Will an arm lift change the sensation of my arm or forearm?

Yes it can.
It is common for parts of the arm and forearm to be numb after surgery. Very small nerves that are barely visible, are removed during excision of the skin from the arm.
While the larger nerves are left behind they may also be traumatised during liposuction which frequently accompanies this procedure. Usually sensation returns over weeks to months, and can take up to 12 months to recover.

Are there any alternatives to an arm lift?

Not really.
Fat excess alone can be treated with liposuction only.
Mild degrees of skin laxity and fat excess can be treated with liposuction and a scar localised largely to the armpit.
However moderate to severe degree of skin laxity and fat excess require a conventional arm lift – loose skin has to be cut out and there are no alternatives to this.

Procedure Pricing

Arm lift surgery attracts a Medicare/health insurance rebate for those who meet the following criteria (the rules changed in 2016):
- Significant loss of weight equal to or greater than 5 BMI points
- Skin condition exacerbated by loose skin and fat
- Skin condition not resolving with 3 months of conservative therapy
In addition to this you need to have the appropriate level of health fund cover.
A quote for this procedure will be provided to you after a consultation with Dr. Aggarwal. You can also call or email our office for our current indicative pricing.

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