Procedure guide
What an arm lift involves, the scar it leaves, and what to expect.
Written by Orr Shauly, MD, plastic surgery resident. Updated .
For information and education only, not medical advice.
The short answer.
A brachioplasty, or arm lift, removes loose, hanging skin and fat from the upper arm, most often after major weight loss, leaving a long scar along the inner or back of the arm.1,2 In a meta-analysis of 1,578 patients, the most common problems were unfavorable scarring (9.9%), recurrent laxity (7.79%) and wound separation (6.81%), with aesthetic revisions in 7.46%.3 Despite the scar, patients who had arm lifts after weight loss reported significantly higher satisfaction with their arms at 2 years.4
- 1,578 Patients
- complication meta-analysis
- Patients in 29 brachioplasty studies, with unfavorable scarring the most common problem at 9.9%.3
- 7.46%
- aesthetic revisions
- Patients who had another operation for aesthetic reasons after brachioplasty.3
- 6 - 12 Months
- stable weight first
- Recommended period of stable weight before body contouring after major weight loss.2
- 12 Months
- for the scar to mature
- Time before the arm lift scar reaches maturity, which patients are counseled to expect.2
What an arm lift is.
An arm lift removes redundant skin and fat from the upper arm to restore a more normal contour. It is increasingly performed after major weight loss, when loose skin hangs from the underside of the arm.1 Aging and weight gain also weaken the supporting tissue of the arm, which contributes to sagging.2
The trade-off is a scar. The most common technique leaves a visible scar along the inner arm, and each patient must decide whether a better contour is worth it.1,2 Textbooks describe it as likely the most noticeable scar in aesthetic surgery.2
Who is a candidate.
Candidates have excess skin, fat or both on the upper arm that diet and exercise have not corrected. After major weight loss, weight should be stable for 6 - 12 months, and nutrition and medical conditions should be optimized first.1,2
Lymphedema of the arms, nerve or vascular disorders of the arm, connective tissue disorders and unrealistic expectations are reasons not to operate, and active smoking, unstable weight, planned pregnancy and a tendency to thick scars increase risk.2 In a cohort of 1,002 patients, complications after body contouring did not differ by how weight was lost, including bariatric surgery or GLP-1 medications, but higher body mass index and diabetes increased risk.5
Arm contouring options.
| Approach | Best Suited For | Evidence |
|---|---|---|
| Liposuction Alone2,6 | Excess fat with minimal loose skin | High satisfaction and no complications in a 28-patient series |
| Energy-Assisted Liposuction7,8 | Fat with mild to moderate skin laxity | 80.6% satisfied in a 176-patient randomized study, without long scars |
| Mini Brachioplasty2,9 | Loose skin near the armpit only | Scar limited to the armpit fold |
| Full Brachioplasty2,3 | Loose skin along the whole arm | Long inner arm scar, with scarring problems in 9.9% |
| Extended Brachioplasty2 | Excess extending onto the chest wall | Scar runs along the arm, through the armpit and onto the chest wall |
Scar placement is debated. A scar in the groove on the inner arm is less visible but can widen, while a scar placed toward the back of the arm may heal finer but is more visible from behind.2 In the brachioplasty meta-analysis, a more medial incision was associated with more complications, while adding liposuction lowered certain complications.3
For moderate laxity with heavy fat, liposuction with laser skin tightening produced similar measured results to open brachioplasty in one comparison of 60 arms, with higher satisfaction, less pain and return to work within about a week.10
How an arm lift is performed.
- Markings: The groove on the inner arm and the planned excision are marked, with care not to remove too much skin.2
- Liposuction: The arm is often debulked with liposuction outside the area to be removed, which can be done safely at the same time.2,11
- Excision: Excess skin and fat are removed while protecting the sensory nerve of the forearm that runs nearby.2
- Armpit: When the incision crosses the armpit, a zigzag design prevents a tight scar band.2
- Closure: The wound is closed in layers, often over a drain, and the arm is wrapped to limit swelling.2
Removing too much skin and being unable to close the wound is the most serious technical complication, which is why markings are conservative.2
Recovery.
Recovery milestones come from a surgical textbook, and many patients can go home the same day.2,12
| Time | What Usually Happens |
|---|---|
| Day 22 | The compressive wrap is removed, the wounds are checked and showering is allowed |
| Week 12 | Drains are usually removed |
| Weeks 1 - 22 | Arms stay wrapped or in compression sleeves and are not raised above the shoulder |
| Week 22 | Gentle range of motion exercises begin |
| 12 Months2 | The scar matures |
Risks and complications.
| Complication | Reported Rate | Context |
|---|---|---|
| Unfavorable Scarring3 | 9.9% | The most common complaint after brachioplasty |
| Recurrent Laxity3 | 7.79% | Return of loose skin |
| Wound Separation3 | 6.81% | Usually managed with wound care |
| Seroma3 | 5.91% | Often drained in the office |
| Infection3 | 3.64% | Usually treated with antibiotics |
| Nerve Problems3 | 2.47% | Numbness or pain from nearby sensory nerves |
| Lymphedema, Lymphocele3 | 2.46% | Fluid buildup from disrupted lymphatics |
In a multipractice cohort of 96 patients, hypertrophic scarring occurred in 24.0% and the total revision rate was 22.9%, and patients with prior bariatric surgery had more major complications.11 Adding liposuction or other procedures did not significantly increase complications in that cohort.11
Results and how long they last.
In 68 patients surveyed at least 2 years after arm lifts following weight loss, BODY-Q satisfaction and SCAR-Q scores improved significantly, and patients reported few concerns about the scar despite its length.4 In a series of 50 patients treated according to severity, arm circumference fell by 6.8% - 17.3%, with greater gains in more severe cases.13
Results last if weight remains stable, although some skin laxity can return over time.2,3
Alternatives.
What we don't know yet.
Common questions.
How bad is the scar after an arm lift?
The scar is long and runs along the inner or back of the arm, and textbooks describe it as one of the most noticeable scars in aesthetic surgery. It takes about a year to mature, but many patients after weight loss report high satisfaction despite it.
Can liposuction alone fix my arms?
If the problem is mostly fat with good skin tone, liposuction alone can work well. When there is significant loose or hanging skin, removing the skin with an arm lift is usually needed.
Do I need to wait after weight loss before an arm lift?
Yes. Textbooks recommend a stable weight for 6 - 12 months before body contouring, with good nutrition and medical conditions under control.
Does the weight loss method matter for an arm lift?
In a cohort of 1,002 patients, complication rates after body contouring were similar whether weight was lost through bariatric surgery, GLP-1 medications or lifestyle change. Higher body mass index and diabetes at the time of surgery increased risk.
When can I return to work after an arm lift?
Arm movement is limited for about 2 weeks, and the return to work depends on the job. Studies rarely measure it directly, so your surgeon can give a personal estimate.
Is an arm lift right for me?
Only an in-person evaluation can answer that. This guide is educational and cannot assess an individual case. A qualified plastic surgeon can review your goals, skin, weight history and health with you.
Key terms.
- Brachioplasty
- The medical term for an arm lift, which removes excess skin and fat from the upper arm.
- Brachial Groove
- The natural groove on the inner arm where the arm lift scar is often placed.
- Extended Brachioplasty
- An arm lift whose scar continues across the armpit onto the side of the chest.
- Medial Antebrachial Cutaneous Nerve
- A sensory nerve on the inner arm that is protected during an arm lift.
- Lymphocele
- A collection of lymph fluid that can form after surgery disrupts lymphatic channels.
- Massive Weight Loss
- Large-scale weight loss, often after bariatric surgery, that leaves excess loose skin.
- Z-Plasty
- A zigzag incision design that prevents a tight scar band across a joint or the armpit.
References.
- 1.Colwell AS, Phillips NA. Brachioplasty and upper trunk contouring. In: Chung KC, editor. Grabb and Smith's plastic surgery. 8th ed. Philadelphia: Wolters Kluwer; 2020. p. 651-62.
- 2.Angelos TM, Janis JE, Mendieta CG. Brachioplasty. In: Janis JE, editor. Essentials of aesthetic surgery. New York: Thieme; 2018. p. 818-27.
- 3.Aljerian A, Abi-Rafeh J, Ramirez-GarciaLuna J, Hemmerling T, Gilardino MS. Complications in Brachioplasty: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2022;149(1):83-95. PubMed
- 4.Barone M, Salzillo R, Amenta A, Brunetti B, Tenna S, Persichetti P. Balancing Aesthetics and Scarring: Insights from Post-Bariatric Brachioplasty. Aesthetic Plast Surg. 2025;49(16):4664-70. PubMed
- 5.Abbott EN, Giannas E, Dorjsuren N, King D, Li R, Christopher AN, et al. Post Weight Loss Body Contouring Surgery: Complication Rates Following Bariatric Surgery, Injectable Glucagon-like Peptide-1 Receptor Agonist Pharmacotherapy, Combination Therapy, and Lifestyle Modification. Aesthet Surg J. 2026;46(9):1029-36. PubMed
- 6.El-Fahar MH, El-Gharbawi AH. Ultrasound-Assisted Liposuction (UAL) Arm Contouring in Non-Post-Bariatric Patients: No Rush for Brachioplasty. Aesthetic Plast Surg. 2023;47(1):260-8. PubMed
- 7.Ibrahiem SMS. Aesthetic Nonexcisional Arm Contouring. Aesthet Surg J. 2022;42(7):NP463-NP473. PubMed
- 8.Wong ZY, Murugan V, Wong ZN, Danpanichkul P, Faderani R, Kanapathy M, et al. Impact of Laser Lipolysis With and Without Liposuction on Arm Circumference: A Systematic Review and Meta-Analysis. Aesthet Surg J Open Forum. 2025;7:ojaf097. PubMed
- 9.Miotto G, Ortiz-Pomales Y. Arm Contouring: Review and Current Concepts. Aesthet Surg J. 2018;38(8):850-60. PubMed
- 10.Fayek M, Rizk IN, Hashem AM, El Sharkawy OA. Outcomes of Combined Liposuction/Laser Skin Tightening versus Open Suction-Assisted Brachioplasty in Moderate Arm Ptosis. Plast Reconstr Surg. 2022;149(5):881e-892e. PubMed
- 11.Zomerlei TA, Neaman KC, Armstrong SD, Aitken ME, Cullen WT, Ford RD, et al. Brachioplasty outcomes: a review of a multipractice cohort. Plast Reconstr Surg. 2013;131(4):883-9. PubMed
- 12.Benoilid M, Rayess Y, Barbera F, Chatel H, Schmitt T, Tresallet C, et al. Is brachioplasty acceptable as an outpatient procedure? A prospective study comparing ambulatory and traditional hospitalization procedures. Ann Chir Plast Esthet. 2020;65(4):294-9. PubMed
- 13.Zhu J, Zhao F, Li F. A Retrospective Analysis of Upper Arm Rejuvenation Surgery in 50 Patients. Aesthet Surg J. 2024;44(4):NP254-NP262. PubMed
- 14.Bianchi A, Salgarello M, Visconti G. Lipobrachiopexy: Cosmetic Outcomes and Limb Lymphatic Function of a Novel Brachioplasty Technique in Massive Weight Loss Patients. Aesthetic Plast Surg. 2022;46(2):786-94. PubMed