BEFORE AND AFTER PHOTOS - BRACHIAPLASTY
There are effective techniques to reduce the size of the upper arms and to get rid of excess skin. What's more, these goals can be accomplished without the tradeoff of lengthy post-treatment scars. 
Many women hide their upper arms, even on the hottest days, because they are unwilling to wear sleeveless or short sleeved shirts. They feel their upper arms are too big or fat compared to their body, or that they have too much loose, hanging skin which gives their arms an unflattering silhouette.
With proper patient evaluation and the right surgical procedures, patient satisfaction with contouring of the arms has been very high. When women have excess fatty tissue of the posterior arm (the part of the upper arm which hangs when the arm is raised), often liposuction alone can offer a satisfactory solution. Plastic surgeons generally use a "pinch test" to determine who is a good candidate for this procedure.
If there is moderate thickness to the arm upon pinch, liposuction treatment may be suitable for you. The excess fat is removed through several tiny incisions in the armpit and by the elbow. The process of removing the excess fat actually encourages the skin to shrink to a significant extent and to conform to the new arm contour.
For patients with excess fatty tissue and skin looseness, a combined approach is needed. The extra bulk or fatty tissue are removed with liposuction. Then the loose skin is pulled upward and tucked into an incision in the armpit to smooth the upper arm. The principle behind this type of arm lift is like pulling up pantyhose. There is no incision placed on the arm itself, like in a traditional armlift, so patients have the freedom to expose their newly shaped arms after treatment.
The best candidates for surgery : The best candidates for surgery are men or women who have any of the following complaints about the appearance of their upper arms: Full, heavy or fatty upper arms, flabby upper arms, loose or hanging skin of the upper arms, arms which are large compared to the rest of the figure .
Surgery on the arm can be performed at any age, provided the patient is in reasonably good health. Anyone who is planning on losing a significant amount of weight may want to postpone surgery until after they reach their weight goal, since weight loss can affect your result. Anyone who smokes needs to quit at least 4 weeks prior to a procedure involving adjustment of the arm skin.
Planning your surgery : In your initial consultation, Dr. Benchetrit will evaluate your health, determine where your fat deposits lie, and carefully assess your skin tone. By taking careful measurement of your current shape and the dimensions of your arms, he can determine the best treatment plan for you. The goal is to decrease the size of the upper arms to create better proportions with the rest of the figure. Skin elasticity, or the ability of the skin to shrink to conform to the arm's new contours, is also important and must be evaluated and discussed. Stretch marks in the skin are one signs of skin damage and loss of elasticity. If there is a lot of loose skin or the skin's ability to shrink is less than optimal, incisions are necessary to perform the surgery. The human body is normally asymmetrical. It is not possible to create perfect symmetry in the arms through surgery. Dr.Benchetrit will review what are reasonable expectations as far as symmetry.
Post -operative swelling is normal after surgery. Most of the swelling should subside in the first couple of weeks after surgery.
Dr. Benchetrit will describe the procedure in detail, explaining its risks and limitations. He will also explain what the recovery will be like, where the surgery will be performed, and the type of anesthesia he will use.
Preparing for your surgery : Dr. Benchetrit will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding vitamins and other medications. Be sure to arrange for someone to drive you home after surgery and to help you out for the first day or two. 
The surgery : Arm liposuction and arm lifts usually take 2 to 3 hours. The time varies depending on the extent of the procedure. To begin the procedure, the surgeon makes incisions to remove excess fatty tissue. This is accomplished with different size hollow tubes called cannulas. The opposite end of the cannula is attached to a machine that creates a strong vacuum. The surgeon manipulates the cannula within the fat layers under the skin, breaking up the fat and suctioning it out. Each area to be suctioned needs to be approached from two different directions.
For liposuction of the arm, there are small incisions placed in the armpit and at the elbow crease. For a modified armlift, there is a small incision at the elbow and one in the armpit to accomplish the skin tightening. These incisions will fade and flatten over time. Dr.Benchetrit will discuss reasonable expectations of your incision's appearance based on your healing history and skin type and discuss with you what you can expect as far 
as skin shrinkage, waviness and pigmentation changes based on your skin tone and quality as well as your pre-operative proportions.
Temporary changes in the sensation of the arm skin is normal after surgery. Permanent loss of feeling is very uncommon.
After your surgery : For the first few days after surgery, you will feel swollen, tight and sore. The discomfort and tightness can be controlled by medication. Do not allow your arms to hang by your sides. You will need to keep your arms elevated on pillows for the first day or two to keep the swelling from drifting into your hands and fingers. You will need to limit your arm motions for the first few weeks after surgery until the incisions are well healed. You should keep your elbows below shoulder level for approximately 2 weeks after surgery.
If you have a drainage tube, it will be removed within a few days. You will apply antibiotic ointment around the drain and on the incisions several times per day. Do not get any of the treated areas wet until instructed to do so. You will be expected to wear a supportive garment to cover the areas that were treated once the compression wraps are removed. Count on wearing it continuously for 3 to 4 weeks. This helps support the skin during healing. The surface stitches will dissolve once you begin showering and the deeper sutures will dissolve gradually over time.
Getting back to normal : Healing is a gradual process. It takes time for the swelling and bruising to disappear and for the skins sensations to return to normal. Iy typically takes up to 3 months for all swelling to disappear. You will be encouraged to exercise as it will help you heal better. Activities such as walking, lower body weights, recumbent bikes and treadmills are permissible as soon as 7 days after surgery. More vigorous activities, such as jogging, aerobics or upper body weights can be resumed approximately 4 weeks after treatment.
At the beginning, your incisions will be noticeable but they will gradually fade and flatten for up to a year after surgery. If you had skin tightening, you will also have puckering around the armpit incision at the beginning. This will smooth out over a month or two. Your skin will also be firm and numb at the outset. It will soften and normal sensation will return gradually.
