Removal of excess skin and fat from the arms
Overstretched skin due to the accumulation of fat during obesity, followed by the deflation caused by weight loss, results in multiple functional and aesthetic irregularities in the arms. Irregularities typical of post-bariatric patients include: inelastic and sagging skin (dermatochalasis), skin folds susceptible to continuous irritation and stretch marks.
In addition to skin loosening, deep connective structures are damaged and muscles relaxed; moreover, fat deposits may persist. Of course, the natural ageing process, with or without weight loss, contributes to a progressive loss of skin elasticity in the inner aspect of the arm.
The brachioplasty procedure is made up of two phases:
- excision of the excess, loosened skin
Liposuction allows removal of fat deposits and contouring of fat tissue in the neighbouring area (liposculpture). It also seeks to minimise intra-operative bleeding and leaves lymphatic and blood vessels intact; these structures would be damaged if subjected to a full-thickness excision. Liposuction allows fat removal and skin-only excision.
Skin excision is performed on the inner aspect of the arms and results in a scar running along the inner and posterior margin of the arm, from the underarm to the elbow. A “Z-plasty” is performed on the underarm, which is a technique used to re-create a natural hollow and an uplift in this region, reducing the risk of scar retraction. Prior to careful application of a skin suture, the underlying connective tissue layer is reinforced with a deep suture. The final result will be more stable and skin tension on the scar will be minimal, which is essential to achieve better scar development.
Brachioplasty is performed under general anaesthesia (the patient is asleep) with a one-night hospital stay after surgery.
Careful administration of pain-killers during and after the surgery ensures that post-operative pain and discomfort are kept to a minimum.