Sydney plastic surgeon Dr Mark Kohout discusses the surgical options to minimise flabby upper arms.

Batwings, arm flaps or just loose arm skin; call them what you will, there is no doubt that loose skin in the upper arm is considered unattractive. No age group is immune to this problem and even if the skin is firm, some people simply have too much tissue in the upper arm. The thickness or circumference of the upper arm can be well out of proportion to the rest of the body.

It makes fitting clothes difficult and wearing short sleeved shirts, T-shirts or singlets becomes very awkward, if not impossible. People with this procedure become selfconscious and it can affect their self-confidence.

There are several diff e rent problems that I see. The first is the young woman who has the out-of-proportion arms that won’t fit into the short-sleeved shirts. They have good, firm skin and no looseness in the skin. All they want is to bring the arms into natural proportions so they are not restricted in what they can wear. This problem is relatively easy to deal with as it can be corrected well with simple liposuction. The tiny 5mm incisions are placed discreetly in the armpit crease and will become virtually invisible in a short period. This procedure can be performed in day surgery with usually no more than a day’s worth of downtime.

The second is the middle-aged person, both male and female, who is starting to show signs of advancing age and wants to turn back the clock a few years. These patients generally have a combination of moderate thickening of tissue in the upper arm and moderately loose skin. Depending on the amount of skin looseness, the incision to remove some of the skin can be completely hidden in the armpit crease or it may have to extend a short distance down the arm. Again, this procedure is very reliable and produces excellent results to a point where wearing of T- shirts is no longer an embarrassing chore. Depending on the extent of the incisions, you may need a few days off work although it can still be performed as a day-surgery operation.

The third type of problem I will see is the patient who has lost a significant amount of weight and can be of any age and either sex. Major weight loss will result in stretching of the skin and skin redundancy when the weight has been lost. Generally, these patients suffer from major embarrassment and will not show their arms at all. In this situation, the incision usually has to extend down the inside of the arm to the elbow. The hairline scar is a small price to pay for a thinner, well-contoured arm which will look great even in short sleeves. This procedure can be performed in day surgery also, although some patients choose to stay in hospital overnight. The recovery time is around a week before returning to work (depending on the type of job).