Loose skin on the upper arms is one of the most common concerns after major weight loss, and one of the most persistent. Exercise can build the muscle underneath, but it cannot shrink skin that has lost its elasticity. After large weight loss the excess rarely stops at the armpit: it often continues onto the side of the chest.
In short: An arm lift (brachioplasty) removes the hanging skin and residual fat from the underside of the upper arm. After major weight loss, an extended brachioplasty carries the incision through the armpit and down the side of the chest, so the excess there is removed in the same operation. The scar runs along the inner arm, where it is least visible with the arms at your sides. It is usually an overnight stay, and a Medicare rebate under item 30169 may apply where the criteria are met.
- Why arms change
- Is it right for you?
- Types of arm lift
- The operation
- Recovery
- Scars
- Cost and Medicare
- Questions
Why the upper arms change after weight loss
The skin on the inner upper arm is thin, and when it has been stretched for years and the fat beneath it is lost, it hangs from the arm in a loose fold. That fold is most obvious when the arm is raised or held out to the side, and it can swing with movement, chafe against the chest, and make sleeves and fitted clothing difficult.
After major weight loss, whether through bariatric surgery, weight-loss medication or lifestyle change, the loose skin usually runs the full length of the upper arm and continues across the armpit onto the side of the chest wall. A standard arm lift that stops at the armpit leaves that chest wall excess behind, which is why the technique is adapted for patients after weight loss.
Is an arm lift right for you?
- your weight has been stable for at least six months, ideally twelve
- the problem is mainly loose skin, not fat that would respond to exercise or liposuction
- the loose skin chafes, causes rashes or restricts clothing and activity
- you accept a scar along the inner arm in exchange for removing the skin
- you are free of all nicotine, or able to stop completely at least eight weeks before surgery and stay off it for eight weeks after
If you have had only modest weight change and your concern is mainly ageing skin near the armpit, the standard brachioplasty (arm lift) page covers the shorter-scar options. Arm lifts are commonly planned after the abdomen has been addressed, and Dr Kumar will discuss the order that suits your overall plan.
See whether an arm lift fits your plan
Dr Kumar assesses how far the loose skin extends, how much fat remains, and where an arm lift sits among any other operations you are considering. A GP referral is required.
Skin or fat: which do you have
| Sign | Points to |
|---|---|
| The arm is full and firm; skin springs back when pinched | Fat with good skin — liposuction, no long scar |
| Skin hangs and swings when the arm is raised | Excess skin — an arm lift |
| Skin stays creased after you pinch and release it | Poor elasticity — an arm lift |
| The looseness continues past the armpit onto the chest | An extended arm lift — see the techniques below |
After major weight loss it is almost always skin.
What does not work
- Triceps training. It builds the muscle underneath, which helps a fuller arm look better. It does not shrink a skin envelope.
- Further weight loss. It empties the arm further and makes the skin hang more.
- Skin-tightening devices. They do not remove skin. An arm that hangs will still hang.
- Liposuction alone, where elasticity has gone.
Types of arm lift
| Technique | Scar | Suits |
|---|---|---|
| Short-scar (limited) arm lift | In the armpit only | Small amount of loose skin close to the armpit; uncommon after major weight loss |
| Standard brachioplasty | Inner arm, elbow to armpit | Loose skin along the length of the upper arm |
| Extended brachioplasty | Inner arm, through the armpit and down the side of the chest | Loose skin that continues onto the chest wall, typical after major weight loss |
| Brachioplasty with liposuction | As above | Where residual fat remains in the arm as well as loose skin |
What the operation involves
Markings are made with you standing, arms held out, so the amount of skin to be removed and the scar line can be planned precisely. Under general anaesthetic, liposuction may first be used where residual fat remains. The loose skin is then removed along the inner arm and, in an extended brachioplasty, through the armpit and down the side of the chest.
The incision in the armpit is shaped so that the scar does not form a tight band across it, which would limit how far you can raise your arm. The skin is closed in layers. Drains are used and are removed by Dr Kumar’s nurses once the drainage has settled. The scar is positioned along the inner arm so it is least visible with your arms at your sides.
Combining with other operations
An arm lift is often combined with surgery on the chest, because the loose skin continues from one to the other. In men it can be combined with male chest contouring after weight loss, and in women with a breast lift. It can also form part of an upper body lift.
Arms and thighs are usually done at separate operations, because having both limbs restricted at once makes the early recovery much harder. After weight loss, keeping each operation within a safe length reduces the risk of complications, so combinations are planned around your health rather than convenience alone.
Recovery, week by week
| When | What to expect |
|---|---|
| In hospital | Usually one night at Westmead Private Hospital. Compression sleeves are fitted, and you will be encouraged to keep your arms raised on pillows to help swelling settle. |
| Weeks 1 to 2 | Time off work. Tightness and swelling in the arms, sometimes extending to the forearm and hand. You can use your hands for light tasks such as eating and grooming, but avoid lifting, pushing up from a chair with your arms or reaching overhead. Drains are removed by Dr Kumar’s nurses once the drainage has settled. First review with Dr Kumar and his nurses at about one week. |
| Weeks 2 to 6 | Most patients return to work from about two weeks, then gradually resume most everyday activities over the next four weeks. How quickly depends on how physical the activity is and the area operated on. No heavy lifting or straining, and drive only once you can do so comfortably and safely. The Prineo and Micropore dressings come off at six weeks, and the compression garment is worn for six weeks. |
| Weeks 6 to 12 | After your six-week review, exercise and more physical work are built up progressively. Most patients are cleared for full activity at the 12-week review. |
| 3 to 12 months | Swelling settles and the scars mature. Reviews at 6 months and 12 months. |
Dressings, garments and scar care are managed by Dr Kumar’s nurses, who also work on the wards at Westmead Private Hospital. The nurses who prepare you for surgery are the same ones who look after you at every post-operative review.
Scars and sensation
The scar along the inner arm is the trade-off for removing the loose skin. It is not visible from the front with your arms at your sides, but it can be seen when your arms are raised or from behind in some positions. Arm scars tend to stay red and firm for longer than scars elsewhere and can widen, so scar care matters. Most fade and flatten over 12 to 18 months, although how a scar matures varies between people.
A sensory nerve runs close to the inner arm, and numbness or altered sensation of the inner forearm can occur. This usually improves, but it can be permanent.
Risks and complications
All surgery carries risk. Risks of an arm lift include:
- wound separation, most often in the armpit
- seroma, a collection of fluid that may need draining
- infection
- bleeding or haematoma
- numbness or altered sensation of the forearm
- prolonged swelling of the forearm and hand
- thickened, widened or tight scars
- asymmetry or residual loose skin
- blood clots
- the need for further surgery
Dr Kumar will go through your own risk profile at consultation. You can read more about the risks of surgery.
Cost and Medicare
Dr Kumar’s initial consultation fee is $400, with a Medicare rebate of approximately $88. A referral from your GP is required to see Dr Kumar. Surgical fees are quoted individually after consultation, once the operation and any staging are settled. The practice does not publish package prices for body surgery.
An arm lift after weight loss may attract a Medicare rebate under item 30169. The item covers removal of redundant non-abdominal skin for functional problems following significant weight loss equivalent to at least five BMI points, where your weight has been stable for at least six months before surgery, for one or two non-abdominal areas. Medicare benefits are not available for surgery performed for cosmetic reasons.
When a Medicare item applies, your private health fund may also cover hospital costs, depending on your level of cover. The hospital runs a fund check before issuing its quote, so your itemised quote shows what your fund covers. The guide to Medicare rebates and plastic surgery explains how the system works, and costs and payment sets out what the quote includes and how the in-house payment plan works.
Results
Surgical photographs are restricted to viewers aged 18 and over. The outcomes shown in any photograph are relevant only to the patient pictured, and individual results will vary. You can view the arm lift gallery and the body contouring after weight loss gallery.
Where Dr Kumar operates
Consultations are held at Westmead, Penrith and Orange. If you live a long way from Sydney, you can send photos to Dr Kumar’s team before your first appointment.
Arm lifts after weight loss are performed at Westmead Private Hospital, an accredited Ramsay Health Care hospital. This operation is one of a group covered on the body contouring after weight loss page.
Common questions
Where will the scar be?
Along the inner upper arm from the elbow to the armpit. In an extended arm lift it continues through the armpit and down the side of the chest. It is positioned so that it is least visible with your arms at your sides.
Is an arm lift covered by Medicare?
It can be, under item 30169, when the loose skin causes functional problems after weight loss of at least five BMI points and your weight has been stable for at least six months. It does not apply to cosmetic surgery. Eligibility is assessed at consultation, and a GP referral is required.
Can liposuction alone fix loose arms?
Rarely after major weight loss. Liposuction removes fat but does not remove skin, and taking fat out of loose skin can make it hang more. It is sometimes used during an arm lift where residual fat remains.
How long before I can drive and go back to work?
Most people take about two weeks off work, then gradually return to most activities, including driving once they can turn the wheel and brake comfortably, over the following four weeks. Lifting and overhead work take longer, and most patients are cleared for full activity at 12 weeks.
When can I return to the gym?
Upper body exercise is built up progressively after your six-week review, and most patients are cleared for full activity at 12 weeks.
Can my arms and thighs be done at the same time?
It is usually better not to. Restricting both arms and legs at once makes early recovery much harder, and after weight loss keeping each operation within a safe length reduces the risks.
Will the scar stretch?
Arm scars can widen over time, partly because of movement and tension across the arm. Careful closure, dressings, compression and scar care help, but some widening can still occur.
Do men have arm lifts after weight loss?
Yes. Men commonly have loose skin on the arms and chest after weight loss, and an extended arm lift is often planned alongside male chest contouring.
Can the scar be shorter?
Only if the looseness is genuinely confined to the arm and the skin still has recoil. Where it does not, a shorter scar leaves loose skin behind. Arm liposuction or arm lift.
Will I still have loose skin at the elbow?
The excision runs towards the elbow, and how far is planned to your own anatomy. Dr Kumar will mark it on you at consultation so you can see where it stops.
Does an extended arm lift help the loose skin at the armpit and side of the chest?
Yes. That is precisely what the extension addresses, by carrying the excision beyond the armpit onto the chest wall.
Can an arm lift be combined with breast surgery?
Often, since both are upper body and the positioning is compatible. It depends on total operating time and your general health. What can be combined.
Talk it through with Dr Kumar
If loose skin on your upper arms is causing chafing, rashes or restricting what you wear and do, a consultation will establish which arm lift fits and how it sits within your overall plan. Dr Kumar consults in Westmead, Penrith and Orange, and a GP referral is required. You can also download the post-weight-loss surgery guide first.
This page is intended as general information and is not a substitute for individual medical advice. All surgery carries risk, and individual results will vary. Surgical photographs on this website are intended for viewers aged 18 and over. Read more about the risks of surgery here.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
