(press release from ASAPS)

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NEW YORK, NY (May 20, 2004) — Upper arm fat, flabbiness or loose, hanging skin are common problems that cause embarrassment and lead some people to avoid wearing sleeveless clothing even on the hottest days of summer. Today, however, an increasing number of women and men are choosing to undergo cosmetic plastic surgery to reduce and recontour their upper arms. More than 10,500 upper arm reductions, technically called brachioplasty, were performed last year, which is an increase of 321 percent since1997, according to statistics from the American Society for Aesthetic Plastic Surgery (ASAPS).

"In the past, aesthetic plastic surgeons would often discourage patients from undergoing upper arm reduction," says plastic surgeon Jose Guerrerosantos, MD, an ASAPS International Member in Guadalajara, Mexico, whose article on brachioplasty techniques appears in the current issue of Aesthetic Surgery Journal , ASAPS' peer-reviewed clinical journal of cosmetic surgery. "As aesthetic surgeons, our goal is always to provide a result in which the surgery itself is as undetectable as possible. Upper arm reduction often requires a visible incision. But we have gotten better at placing the incision so that it is relatively inconspicuous, causing the least possible concern to patients."

Some patients, generally those with excess upper arm fat but good skin tone, can achieve contour improvement with liposuction alone, requiring only tiny incisions. However, for patients requiring more extensive surgery, the brachioplasty incision usually begins in the armpit area, called the axilla, and runs along the underside of the upper arm. According to Dr. Guerrerosantos, the length of the incision may vary, depending on the severity of the contour problem. In all cases, the goal is to place the incision so it is not visible with the arms in their normal resting position.

A number of factors, some interrelated, may contribute to sagging of the upper arm tissues. These factors include heredity, aging, fat accumulation, hormonal changes and significant weight loss. "The dramatic increase in the number of brachioplasties being performed may reflect the general upward demand for body contouring procedures in post-bariatric surgery patients who have lost a hundred pounds or more," says plastic surgeon Charles Hughes, MD, of Indianapolis, IN, chair of the ASAPS Body Contouring Committee. "Frequently, massive weight loss patients seeking contouring of multiple body areas will say, 'fix my arms first' -- it's that much of a focal point for them."

Upper arm reduction is a procedure that requires a great deal of surgical skill. In removing excess fat and skin, it is important to protect the delicate structures of the upper arm, including the veins and superficial nerves. To help achieve optimal results, patients may be instructed to wear pressure dressings for an extended period after surgery, especially at night. Patients also may be advised to avoid physical exercise for at least one month after brachioplasty.

"Like all plastic surgery, brachioplasty should be undertaken only by a trained surgeon with significant experience in this type of operation," says ASAPS President Peter Fodor, MD, of Los Angeles. "Patients considering upper arm reduction should consult with a board-certified plastic surgeon who is a member of the American Society for Aesthetic Plastic Surgery. In addition, patients must clearly understand that, in this procedure, the tradeoff for a more aesthetic upper arm contour is a scar that may be relatively long and, in certain arm positions, visible."

Dr. Guerrerosantos agrees that patient education about the procedure is extremely important, adding that patients are overwhelmingly pleased with the elimination of unattractive flabbiness and hanging skin in their upper arms. "Using refined techniques for this operation helps to improve the final appearance of scars," he says. "Brachioplasty is a safe and effective procedure that can produce a high level of patient satisfaction."