Massive weight loss may leave large excesses of skin and tissue along the underside of the upper arm, the side of the chest, and in the armpit area. These areas can be re-contoured in a single surgery that often includes a breast lift and/or breast augmentation with your own tissue transferred from the side of the chest or armpit area. These procedures are called brachioplasty and axilloplasty
Brachioplasty (Upper Arm Lift)
Brachioplasty removes loose, sagging skin from the inner side of the upper arm (from the armpit to the elbow). Massive weight loss causes the thin skin in this area to hang down when the arm is raised, which creates what is commonly called a “bat-wing” appearance. Women, in particular, are very self-conscious about this deformity. Although they may be extremely self-conscious about wearing short sleeves, they have difficulty finding long sleeves to accommodate all the loose skin.
A brachioplasty removes the sagging skin through an incision that runs along the inner portion of the upper arm. This incision will probably be visible when the arm is raised, but many patients prefer the scar to the hanging tissue that may flap around when the arm is moved. A brachioplasty takes 1-1/2 to 2 hours and can be done at the same time as other body contouring procedures.
An axilloplasty removes the excess skin and fatty tissue in the armpit area (called the axilla) that may hang in a large fold down the side of the chest following massive weight loss. This procedure takes 1 or 2 hours, depending on the extent of excision needed. Because tissue from the axilla area is useful for adding volume to the breast, an axilloplasty is often combined with a breast lift and breast augmentation with a patient’s own tissue to restore breast volume. (See the section on breast lift and augmentation in massive weight loss patients.)
Axilloplasty requires an incision that begins near the front of the armpit and extends downward several inches toward the base of the breast. The sagging skin is pulled forward, the skin excess is cut off, and the incision is closed with stitches. The resulting scar is well hidden in the body’s natural contours.