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Get to your goal weight and maintain: you want to lose as much weight as you can prior to surgery. However, it is important that you attain your goal weight and comfortably maintain that weight as well. An abdominoplasty removes all of the excess skin and fatty tissue, tightens your abdominal muscles, and gives you a flat, toned look Effectively, without affecting your buttocks size or shape. Liposuction may be an option as well to contour and enhance your natural curvature but it is not a solution to weight loss.

Liposuction can help achieve a slimmer look "from the side". Liposuction will remove any fatty tissue from your abdominal and flank regions and will contour and define the natural curvature of your waist/hips. A tummy tuck would be another option to if you also had to remove excess skin. Your skin quality and amount of fatty tissue will determine which procedure(s) is right for you.

Generally with a large amount of weight loss, skin sagging is common. Liposuction is used to remove fatty tissue but does not address the excess skin. A brachioplasty will remove the excess skin to contour your arms and for a slim toned look to your arms. Scarring from this procedure is the biggest concern amongst patients however the incision is placed underneath the arms and will, over time, fade.

You want to be at your ideal weight, a weight that you can comfortably maintain for at least 4-6 months, before undergoing a tummy tuck or liposuction procedure. Being at your ideal weight and losing any weight before surgery is important since this will better determine the amount of skin that can be removed and areas that will need contouring, ultimately leaving you with a better aesthetic result.

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Brachioplasty Plastic Surgery (Arm Lift)

1. OVERVIEW

Aging, fluctuations in bodyweight, and heredity can cause the skin (and fat) on the underside of your upper arms to droop and sag. An arm lift, or brachioplasty, is a cosmetic surgical procedure which can effectively restore a more youthful and toned appearance to your upper arms by removing excess skin and localized pockets of fat from the affected areas.

2. IDEAL CANDIDATES

The best arm lift candidates are healthy, non-smoking adults who are unhappy as a result of having significant upper arm skin laxity (with or without localized fat deposits). Candidates should ideally have a relatively stable and normal body weight, in addition to having realistic expectations with regard to surgical outcomes.

3. THE PROCEDURE

3.1. ANESTHESIA

  • The procedure is typically performed under general anaesthesia.

3.2. TECHNIQUES

The location and the amount of excess skin to be removed will generally dictate the technique (and consequently the incision pattern and length) that will be used to perform your arm lift procedure. There are essentially three different techniques which can be used: the limited technique, the traditional technique, and the extended technique. Regardless of the technique used, in the presence of excess upper arm fat, liposuction is performed to remove excess fat before skin incisions are made.

3.2.1. LIMITED TECHNIQUE

  • This technique is typically indicated for patients who only have proximal upper arm (i.e. in the vicinity of the armpit) skin redundancy.
  • An elliptical or T-shaped skin excision pattern just outside the armpit (axilla) results in a linear or T-shaped scar pattern, respectively, following skin closure.

3.2.2. TRADITIONAL TECHNIQUE

  • This technique is typically indicated for patients with skin redundancy of the entire upper arm, that is, from the elbow up to, but not including, the chest wall.
  • The incision is usually placed along the inner surface of the upper arm, and extends from the elbow up to the axilla. Excess skin and fat are subsequently removed from the inner aspect of the arm and axilla to allow for the advancement and tightening of redundant skin from the underside of the arm.
  • Wound closure results in a linear scar pattern along the inner aspect of the upper arm, extending from the elbow to and along the periphery of the axilla.

3.2.3. EXTENDED TECHNIQUE

  • This technique is typically indicated for patients with skin redundancy along the entire upper arm and onto the lateral chest wall.
  • The incision is once again placed along the inner surface of the upper arm, and then continued from the axilla down along the lateral chest wall, and may extend as far as the fold beneath the breast, if necessary.
  • Wound closure once again results in a linear scar pattern which runs along the inner aspect of the upper arm. A zigzag pattern closure is performed within the axilla to avoid postoperative scar contracture. Lastly, a linear closure is performed of the wound along the lateral chest wall.

3.3. WOUND CLOSURE

  • All wounds are closed in multiple layers over surgical drain with absorbable sutures and skin staples which will be later removed.

4. PREOPERATIVE CONSULTATION

Dr. Lee will perform a thorough medical evaluation during your consultation to ensure that you are medically fit for surgery. He will also revise your medication list, as certain medications may need to be temporarily stopped before your surgery.

After carefully evaluating your arms and chest, and assessing your aesthetic goals, Dr. Lee will review your available surgical options and help you choose a treatment plan that will allow to achieve your desired results.

Since smoking is known to be associated with poor/delayed wound healing, wound dehiscence, wound infections, and increased scarring postoperatively, smokers will be asked to stop smoking 4 weeks prior to surgery, and for at least 2 weeks postoperatively1.

Patients will also be scheduled for routine pre-operative blood testing and an electrocardiogram 1-2 weeks before surgery. If necessary, further recommendations will be made once the results of these tests have been reviewed.

4.1. COMBINED PROCEDURES

  • Patients who are also bothered by excess sagging skin in other areas of their body could consider combining their arm lift with another body contouring procedure (i.e. “tummy tuck” and/or breast lift). Combined procedures offer patients the advantage of treating multiple areas of their body in one operative setting with a shorter overall recovery period.

5. RECOVERY

The operation is performed on an outpatient basis and most patients are permitted to go home a few hours after surgery.

There will be dressings over your upper arms after surgery. You will also be given a surgical garment or compression wraps to wear for the first 4 to 6 weeks. Before leaving our facilities, you will be given specific instructions on how to care for your surgical wounds throughout your recovery. It is imperative that you follow these recommendations in order to minimize the appearance of your scars and to optimize your final results. Dressings should be left place until your first post-operative visit with Dr. Lee, at which point he will assess your wounds and if necessary, apply new dressings.

You will experience some discomfort; however, this can be controlled with the pain medications which will be prescribed for you. Some swelling and bruising are expected for the first 3-4 weeks after surgery. Although the results of your arm lift surgery will be immediately apparent, it may take up to 6-12 months for your scars to fully mature, swelling to completely resolve, and achieve your final look.

Most patients are able to return to work or school after about a week of convalescence. For the first 4-6 weeks, patients are asked to avoid excessive/repetitive movements with their arms or lifting anything over 5 pounds. Light exercises are permitted at 2 weeks, while regular exercise and activities can be resumed at 4-6 weeks.

6. RISK AND COMPLICATIONS

As with any surgery, there are risks associated with arm lift surgery. Smoking, diabetes, peripheral artery disease (poor circulation), as well as heart, lung, or liver disease may increase your risk of perioperative and/or post-operative complications.

Arm lift risks/complications include:

  • Risks associated with anesthesia
  • Bleeding (hematoma)
  • Infection
  • Poor wound healing
  • Scarring (hypertrophic scars)
  • Fluid accumulation (seroma)
  • Damage to deeper structures (such as nerves, blood vessels, muscles) may occur and the consequences may be temporary or permanent
  • Fat necrosis
  • Altered skin sensation or numbness

Post-operative scarring

Scars form as the body’s natural response heal tissues. As with any scar, the extent of post-surgical scarring depends on a number of modifiable factors (i.e. avoidance of UV light exposure, tension-free wound closure, appropriate wound care, etc.) and non-modifiable factors (i.e. patient age, comorbidities, skin type, genetics, etc.). While it is not possible to perform scar-free surgery, Dr. Lee makes every effort to minimize the appearance of your post-surgical scars through careful pre-operative planning, the use of meticulous surgical technique, and by ensuring appropriate wound care and follow-up post-operatively.

It is not unusual for scars to appear red and be slightly raised/firm for the first 4-6 weeks following surgery. Scars will flatten and become more pale over time, and can take up to 12 months before achieving their final appearance.

Dr. Lee will thoroughly discuss these risks (and possibly others) with you and answer any questions you might have prior to obtaining your consent for surgery.

Office of Dr. James Lee:

  • 2540 Daniel Johnson, Suite 905 Laval, QC,
  • Tel: 1(514) 664-2076

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