Bat Wings Are Not As Cool As They Sound!

Bat Wings (Brachioplasty)

So many of us have what are known as “bat wings” or “tuckshop arms”! Often occurring after substantial weight loss, they are a pendulous fold of redundant skin and flap, especially evident when the arms are outstretched. In the past decade, the number of patients undergoing a brachioplasty, or arm lift, is certainly on the rise.

Australia is one of the most obese countries in the world. However, this also means we have a large number of the population losing a large amount of weight at any one time.

How can A Brachioplasty help?

Brachioplasty is a surgical procedure for the arms. It is commonly called an arm lift. The aim of this is to improve the shape of the under portion of the upper arm and the connecting area of the chest wall to the elbow, and for a more toned and proportionate appearance. More often, this is done to simply eliminate the loose skin and excess fat in the arms of those who have experienced a massive weight loss. Though exercise can help tighten the muscles, it cannot do anything with the drooping and sagging skin that has lost elasticity due to weakened tissues and fat deposits.

“Brachioplasties are especially satisfying for those who are at the end of their weight loss journey. Many consider the surgery due to having an unsightly amount of excess skin hanging on the under-side of the arms. ‘Tuckshop’ arms are due to a combination of prior obesity and poor skin elasticity. As weight is lost, the skin fails to contract down over the reducing thickness of subcutaneous fat, and instead hangs down. Having an arm lift is sometimes the way to fully complete a massive weight loss journey.”

Do I need a Brachioplasty or Arm Liposuction?

A brachioplasty removes redundant skin and fat.  “Liposuction only removes fat, and will often cause or exacerbate skin redundancy especially where skin elasticity is poor. Liposuction alone is rarely indicated, whereas the need for brachioplasty is commonplace, and concurrent liposuction is rarely performed. “ Very few patients are suitable for ‘scarless arm reduction’ or arm liposuction – you would need to be young and have very good skin quality.

What is involved in a Brachioplasty operation?

Performed under a general anaesthetic a brachioplasty involves cutting on the underside of your arm from the armpit to the elbow. Each surgeon has their own technique for doing this, but it depends on how much skin has to be removed and which surgeon is to perform the operation.

The procedure requires anaesthesia. Once the patient is unconscious, the surgeon will make an incision under the arm, right above the elbow. The incision will depend on the amount of skin that needs to be removed. The incision is made on the back or inside of the arms, which may extend from the armpit (axilla) to just above the elbow. After the incision, the surgeons will then remove the skin and fat, tighten the underlying tissue and reform the tissue with stitches. Surgeons will then smooth the skin over the new contoured arm and will then close the incision with absorbable sutures, or stitches that will be removed within 1-2 weeks following the arm lift. Swelling and bruising are normally seen after the arm lift procedure. However, smoother and well-toned arms will be seen and felt right away. The result is permanent, but it is also best to maintain a good diet and workout to keep the tone and shape.

So, are there any downsides to a brachioplasty?

You need to keep in mind that you will have a scar that is noticeable from a brachioplasty procedure. Whilst this may fade with time, it is in quite a prominent position that is hard to hide especially when you wear singlets or swimwear and lift up your arms – having said that; it is obviously more desirable to have a faded scar than a whole lot of skin hanging loose, out of place with the rest of your body.

“Almost invariably, the scar runs from the inside of the elbow up the part of the area hidden whilst your arm is by your side, to the armpit or axilla. It is usual for there to be a “Z” shaped scar in the axilla, to prevent scar contracture there”. Where the degree of skin redundancy is minor, it is possible to perform a less powerful brachioplasty with purely axillary scar.

Whilst the scar is usually of excellent quality, scars can become hypertrophic or keloid, which is to say, raised, red, lumpy and itchy. This is uncommon to rare in Caucasian people.”

It is likely you will have bruising and swelling in the days/weeks afterwards and you will experience varying levels of discomfort and some pain which can be managed according to your surgeon’s instructions.

“You may also have a drainage tube to help get rid of excess fluid in the area, however I personally do not use such drains.

“Many things can be done to maximize scar quality. Permanent or long-lasting absorbable sutures used in the subcutaneous tissues are shown to narrow eventual scar widths by some 40%, as is the postoperative usage of external Micropore tape support for at least 4 months. Following that period, we switch over to the twice daily application of silicone ointments for another 4 to 6 months, to accelerate scar maturation and reduce risk for hypertrophic and keloid scarring.”

BRACHIOPLASTY: A simple description

We also suggest you take the time to find a surgeon who is well experienced in performing your brachioplasty. This will increase your chances of having a less noticeable scar that will heal more neatly over time.

We also suggest you check out our Wounds, Scars and Stretchmarks treatment page on the website to find out more about ointments that can assist with reducing your scarring.

What preparation do you need for brachioplasty?

  1. Supplements, aspirin, and anti-inflammatory drugs may increase bleeding.
  2. Stop smoking 6 weeks before surgery.
  3. Change or start current medications (as per advice).
  4. Fasting (as per advice).
  5. Ask your doctor what other preparation you need before and after surgery.

Brachioplasty Aftercare Instructions:

  1. The incision will be bandaged. An arm compression or elastic bandage is needed to prevent swelling.
  2. A dressing may be applied to the incision for quick healing.
  3. You may be given oral medication to prevent infection and for quick healing.
  4. Learn the signs of infections.
  5. Attend your follow-up and check-up appointments.
  6. Learn how to properly remove the bandage.
  7. Know when to resume regular activities.

Note: Always follow your surgeon’s advice. These instructions are provided as just a guide.

For a detailed description of brachioplasty, click here.

To avoid as much risk as possible and bring about the best result in brachioplasty, be sure to choose a Plastic Surgeon who is well versed in all body contouring procedures, including brachioplasty.

Further Reading About Brachioplasty / Arm Lift Surgery