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. We recently heard a wonderful presentation by Dr Joseph Hunstad at the 38th Annual ASAPS Conference and this coincided with a spate of brachioplasty enquiries so we thought we’d give you a rundown on the what’s and how’s of brachiplasty, or arm lifts.

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. One of our highly-skilled, contributing Australian Plastic Surgeons, Dr Mark McGovern from the VIE Institute in Maroochydore in Queensland, says, “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.”

Brachioplasty Versus Liposuction

A brachioplasty removes redundant skin and fat. Dr McGovern elaborates, “Liposuction only removes fat, and will often cause or exacerbate skin redundancy especially where skin elasticity is poor. In my practice, liposuction alone is rarely indicated, where the need for brachioplasty is commonplace, and concurrent liposuction rarely performed. “

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 you have to be removed and which surgeon you have to perform the operation.

So, are there any down sides 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.

Dr McGovern has this to say on the scars. “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. Dr McGovern expands, “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.”

We also suggest you take the time to find a surgeon, such as Dr McGovern, 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.

If you would like more information on Dr Mark McGovern click here, or you can phone him at the VIE Clinic directly on 07 5479 2922.