I’m Dr. Bill Aydin, board certified plastic surgeon and partner with the New York Group for Plastic Surgery. With the warm weather finally arriving, a common refrain we hear in our offices goes something like this: “I have ‘wings’ under my arms, and I can’t stand the loose skin and fat hanging there!”

The upper arms can be an aesthetically frustrating part of the body.  You may try your hardest to tone your arms by weight-lifting and other arm-targeted exercises, but sometimes it helps only minimally or not at all. Or, a substantial weight loss, such as achieved with bariatric surgery, may have left you with an abundance of excess, loose skin on your arms. And for many of us, the “wings” of fat and skin that develop as we get older are simply a result of genetics or a just having a certain body type.

The American Society of Plastic Surgeons (ASPS) recently reported that about 15,500 arm lift plastic surgery procedures were performed in this country in 2012, up by 3 percent from the prior year. The ASPS found that women sought 98 percent of these procedures, and age also had a strong influence, with arm lifts most common among people over the age of 40. ASPS speculates that the rise in arm procedures is in part motivated by fashions and by celebrities showing off their own shapely arms (think Michelle Obama!)

Upper arm slackness is a challenge faced by many women because the skin between the shoulder and elbow is thin and thereby loses its elasticity and starts to hang. It’s a combination of fat and loose skin that creates the under arm “wings.” When consistent exercise doesn’t help, plastic surgery can offer options for tighter, toned upper arms.

Many people are candidates for an arm lift using a minimally invasive procedure called Smartlipo, in which a cannula (thin tube) inserted through tiny incisions into the upper arm uses a laser to loosen and “melt” the fat, which is then suctioned out.  The laser also helps the skin to maximally retract, or tighten, after the liposuction is complete.  The scar from Smartlipo is only a 2-3 mm incision at the elbow for insertion of the cannula and laser. After the procedure, however, it’s important to wear post-op compression arm garments for 6-8 weeks to make sure the skin retracts and the best results are attained.

Alternatively, some patients simply have too much excess under arm skin, either from substantial weight loss or if they are above age 60, and Smartlipo is unlikely to provide optimal results.  Instead, they will need direct excision, or removal, of the excess skin along with the fat in a surgical procedure called brachioplasty. The benefit seen with brachioplasty is that the upper arms become quite tight, while the drawback is a scar that extends from the elbow to the axilla, or armpit, on the inside of the arms. However, the scar should fade nicely with time (6 months to a year) if properly cared for with massage and scar care such as certain creams.  As with Smartlipo, it’s very important that compression garments be worn after brachioplasty arm lift surgery. Both of these types of arm lift procedures can be done as outpatient surgery in our offices. Smartlipo takes about 1.5 hours, while brachioplasty takes about 2 – 2.5 hrs.

We advocate a diet and exercise plan that keeps your body toned and healthy, but if your upper arms have you self-conscious as the weather heats up and layers come off, we can talk about a procedure that might enable you to proudly bare those arms!