Bat Wing Surgery Scars--A Hefty Price

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If you have loose skin and fatty tissue hanging from your upper arms—the dreaded “bat wings”—chances are you’ve gnashed your teeth when you look in the mirror. You remember how your arms used to look and wonder if you should confine your selection of tops to only those with long sleeves. You may have even considered cosmetic surgery to tighten your arms up again.

There is a plastic surgery procedure, in fact more than one, that addresses “bat wings.” It’s called brachioplasty, or more informally, an arm lift. Just over 160,000 people chose to undergo brachioplasty in 2009, about two-tenths of one percent of total cosmetic surgeries last year, according to the American Society for Aesthetic Plastic Surgery. So, while brachioplasty is not exactly rare, it’s far from being one of the more popular procedures.

At first glance that low number might seem perplexing. The upper arm area is one place where the aging process can leave a harsh mark. The skin in the region is thin and not very elastic, meaning it does a poor job of holding fatty tissue taut over the years. Gravity takes its toll on the upper arms, just as it does on the face, thighs, rear end and other parts of the body—but sagginess is even more noticeable on the arms than it is many other places.

So why don’t more people go in for arm lifts? The short answer—or in this case, the not-so-short answer—is the scar that runs from the armpit to the elbow. As one Seattle plastic surgeon writing on www.realself.com puts it, “Despite the efforts of generations of surgeons-the scars for arm-lift procedures tend to be some of the poorest quality scars we put on our patients…”

The main reason for this is the same one that contributes to lax upper arms in the first place: the skin is thin and inelastic. This means it doesn’t have the ability to bounce back from a surgical incision and heal very smoothly in most cases. This same Seattle surgeon also notes that the arm is always in motion, putting additional stress and strain on the area that can result in scars that are wider, redder and/or more raised than they would be on another part of the body.

A handful of patients may get by with a modified brachioplasty, referred to sometimes as a minimal scar brachioplasty, mini-brachioplasty or an arm tuck. This procedure places the scar in the armpit where it is much less visible. Unfortunately, most plastic surgeons recommend this procedure for just a few clients whose sagginess is mainly in the very top portion of the arm.

There’s also the option to have liposuction on your upper arms. Here again, the pool of candidates suitable for improvement with just liposuction is small, confined to those who have fatty deposits and skin with good tone. Some physicians would have you try one of the newer types of liposuction, or even Thermage skin tightening. You may want to research some of these alternatives if your upper arms are troubling you.

Most doctors seem to agree that if you have relatively minor skin laxity and flabbiness, the armpit-to-elbow scar of the traditional, and most effective, brachioplasty may not be a sensible trade-off. If you’re longing to wear tank tops again, you may find that hiding the scar from surgery is almost as frustrating as trying to hide the old bat wings.

Patients who have lost a significant amount of weight seem to be the people for whom brachioplasty is a welcome relief. Weight loss patients chiming in on www.realself.com make comments ranging from “extremely happy” to “totally worth it.”

If any kind of across-the-board recommendation can be made about any cosmetic procedure, brachioplasty might be the one. Here it is: if you have a little lax skin and fat related to the aging process, you might want to save your money for a facelift where skin can be tightened and scars hidden. Or even simply trade your tank tops in for short-sleeved or three-quarter sleeved shirts.

But, if you’ve lost a significant amount of weight, or if you’re overweight and carrying excess rolls and flaps on your upper arms, you might be the right candidate. Consult with more than one board-certified plastic surgeon and consider carefully…scars or skin?

Resources:

http://www.surgery.org/sites/default/files/2009stats.pdf

http://www.realself.com/question/procedure-tighten-arm-skin-scars

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