Minimal-incision brachioplasty: a first-choice option in arm reduction surgery.
OBJECTIVE
The reader is presumed to have a broad understanding of plastic surgery procedures and concepts. After studying the article, the participant should be able to:Physicians may earn 1 hour of Category 1 CME credit by successfully completing the examination based on material in this article. The examination begins on page 309.


BACKGROUND
Many women complain that the combination of loose skin and excess fat deposits in the upper-arm area inhibits them from wearing sleeveless clothing. Most of these women are reluctant to undergo arm reduction surgery in part because of the highly visible scar that results from a standard brachioplasty.


OBJECTIVE
A new arm reduction technique is described that significantly reduces both the arm circumference and the visual vertical height of the arm when held outstretched, while concealing the scars so as to not inhibit the wearing of sleeveless clothing.


METHODS
Nine patients aged 25 to 75 years underwent the minimal-incision brachioplasty procedure. This included lipoplasty of the upper arm, wide-axillary and upper-arm skin excision, and dermal suspension of the upper-arm skin to the axillary fascia. The patients' arm circumferences were photographed and measured preoperatively and postoperatively.


RESULTS
All patients achieved significant reductions (15% to 25%) in arm circumference measurements as measured at the levels of the distal deltoid insertion and at the mid arm. The scars in all patients were smooth and flat, without hypertrophy. Most of the hair-bearing axillary skin was removed with this procedure, a side effect that all patients viewed as positive. All but one patient expressed satisfaction with the results.


CONCLUSIONS
The minimal-incision brachioplasty technique can be used as the first-choice procedure in arm reduction. Slight modifications of the procedure may be necessary in patients with massively obese arms and in older patients with poor skin tone and minimal elasticity.(Aesthetic Surg J 2001;21:301-310.).
Richards
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ME