PSC Roundtable

Taking Aim at Aging Arms

Taking Aim at Aging Arms

In all of plastic surgery, the aging arms seem to be afterthought. The breast, abdomen, unconquerable fat pockets, and facial wrinkles and lines seem to take precedence and garner the most attention, yet there are many patients who struggle with their arms. Loose skin, extra fat, and textural skin aging combine to form a real problem – one that exists both with sleeves and without.

Board certified plastic surgeons Dr. Ned Snyder and Dr. Stafford Broumand discuss the issues patients face with their aging arms and what modern tools they utilize to achieve rejuvenation.

The Top Concerns Regarding Aging Arms

The arms age just like the rest of the body. Time, gravity, and sun exposure combine to form aged, crepey skin, fat pockets, and skin sag. Weight gain and loss can also contribute to a situation where vast amounts of excess skin exist, causing a cosmetic condition known as “bat wings”.

Aging arms - bat wings.

For patients looking to rejuvenate their arms, the good news is plastic surgery has not forgotten about the area and has modern tools to achieve rejuvenaton. “There are many things we can do for arms,” begins Dr. Broumand, a board certified plastic surgeon in New York City. “We can treat the skin with ultrasound skin tightening to try and get rid some of that crepiness. Or we can get rid of the fat that’s causing the bat wings, that you get underneath your arm. Or we can do surgery where we remove the skin and try to conceal the incision along a line between the elbow and the armpit.”

Skin Tightening with Ultrasound

For some patients, ultrasound skin tightening can fashion great results. Ultrasound devices do not require surgery, as they transmit ultrasound waves that heat and thus tighten the skin in targeted areas. Ultherapy is one such ultrasound device that aims to tighten skin and has found success – in the right patient.

“Some people are great candidates for Ultherapy, but people who come in who have a lot of extra skin aren’t going to be helped,” shares Dr. Snyder, a board certified plastic surgeon in Austin. “It’s a great treatment for those who just feel like they had great looking arms 10 years prior and begin to show some age. Surgery will be required for that person who has a lot of extra skin.”

Fat Removal

Beyond skin, fat pockets may grow in the arm that are seemingly diet and exercise resistant. Depending on the severity of fat deposits, a surgeon may opt to use the fat-dissolving injectable Kybella. Kybella is used routinely to remove unwanted fat underneath the chin, but can also be used wherever small pockets need to be eliminated. When larger amounts of fat are present, liposuction will be the answer.

Arm fat removal via kybella.

The Main Issue with Aging Arms – Excess Skin

When most think of aging arms, they conjure the image of loose, flabby skin hanging underneath the arm – a condition unofficially known as “bat wings.” The loose skin can be as simple as a product of aging, but typically is the fallout from weight gain and/or loss over time. Skin that hangs is far too excessive to treat non-surgically via ultrasound, a situation where surgeons opt for an arm lift procedure, or brachioplasty.

An arm lift is a surgical procedure that removes excess skin, tightening the arms contour. While the results in terms of skin and fat removal are wonderful for recreating great contour, it comes at a cost: a scar. The arm lift scar is notorious as it is one of the largest of any plastic surgery procedure. Patients are often turned away from surgical arm rejuvenation because of this scar, yet it may be less of a concern than they might think.

“It may take 18 months until that scar looks good, that’s an important consideration,” shares Dr. Snyder. “I think it’s fair to tell patients that if they don’t wear short sleeves anyway, they may still not wear short sleeves but they can at least wear sleeves that show the contour and shape of their arms.”

Arm lift before and after - Dr. Broumand.


Dr. Snyder speaks to what patients are really after. If their aging arms are causing issue with their clothing fitting right, the scar will be the trade-off to contour. The scar is placed usually from the armpit down as far as the elbow, “hidden” underneath the arm. It may or may not be visible in short sleeves, but certainly would be if a patient showed their inner arm up close. Aggravating, yes, but the benefit patients receive in clothing is undeniable.

Also, the scar is in proportion to how much skin and fat were removed surgically. This means that those who would have a big scar post-op had a significant amount of loose skin prior, so much so that it would have readily been evident with or without sleeves. For these patients, the price of the scar is the ability to once again have a great contoured arm no matter their clothing option.

“It’s reasonable expectations,” shares Dr. Broumand. “We can’t make them look like they have the arms they had when they were 14 years old, but it’s going to be something that’s better than what they have now without the volume and excess skin.”

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