The Rise of Local-Anesthesia Arm Lifts: What You Need to Know
Dr. Traci Temmen M.D.

Having excess skin around the arms can make it difficult to find shirts and tank tops that a woman feels comfortable and confident in. She may worry that the appearance of “bat wings” (floppy skin of the upper arms and axillary region) is embarrassing, and she seeks out help. Patients come to me after major weight loss or general aging, complaining of “sagging or drooping skin” in their arms. The solution to this issue is simple: arm lift. An arm lift, also known as brachioplasty, is a surgical procedure that is growing in popularity among patients in the Tampa area. During this procedure, loose/excess skin around the arms is removed and tightened, giving the appearance of youthful, toned arms. This procedure has traditionally been performed under general anesthesia; however, I have found that with some of my patients, local anesthesia is the best option for them. In this blog, I will explain the different types of arm lift, how it is performed under local anesthesia, who makes a good candidate, the recovery period, and the overall results.

What exactly is an arm lift? What are the factors that play into it?

The goal of an arm lift surgery is to reduce the amount of sagging skin and tighten the arms. The details of this procedure vary from patient to patient, as everyone has different anatomy. This is something that we take into special consideration at Temmen Plastic Surgery, considering all aspects of a patient’s lifestyle and tailoring a specific plan to them. For example, some patients have more skin laxity than others, which can be attributed to genetics or age. A patient who comes to me at 50 years old typically has less skin laxity than a 75-year-old patient, as skin elasticity decreases over time. Another factor that comes into play when creating the best surgical plan for a patient is the amount of excess fat. If a patient has undergone a major weight loss using a GLP-1 or through exercise, the amount of residual fat may fluctuate as the body returns to its baseline. As you can see, each patient differs in their story and genetics, which is why my team and I at Temmen Plastic Surgery create a personalized plan for you.

What are the different types of arm lift procedures?

Diving into the different kinds of arm lifts, there are three different types I perform. The first being liposuction alone. I do what is known as circumferential liposuction, which promotes skin retraction postoperatively in addition to removing fat. This is something I do for patients who may be a little younger and have less skin laxity, but still a good amount of excess fat. By simply doing liposuction, the scarring is minimal, and my patients undergo a shorter recovery period while successfully contouring their arms. However, liposuction alone is not the best choice for many of my patients, and more needs to be done to deliver the results they desire.

The second kind of arm lift I will complete is a combination of both liposuction and skin excision. This is for patients who still have a good amount of excess fat but may have moderate skin laxity and sagging. Even by using the term “moderate”, this procedure looks different from patient to patient depending on their anatomy. On patients who show excess sagging on the upper one-third of the arm, I will place an incision inside the armpit crease allowing me to lift the skin and hide the scar. This is also known as a “mini arm lift”. In every case, my goal is to reduce as much visible scarring as possible and leave the smallest number of incisions, while still delivering optimal results. In my patients who have sagging across the entirety of their upper arm, I will place an incision vertically along the inside of the arm. While this is not the most ideal aesthetically, it is what allows me to remove the greatest amount of skin and fat in a patient. Being a female board-certified plastic surgeon of 14 years, I use only the best suturing techniques on my patients to help them heal seamlessly. However, it is still important to consider that all bodies heal differently, and scarring is heavily based on genetics.

The third and final type of procedure I perform is a two-stage arm lift. This surgery is split into two surgeries, completed about three months apart. During the first surgery, I aim to remove all the excess fat through circumferential liposuction. After the patient has ample time to heal and swelling/stress on the body has subsided, I complete the second part of the surgery to remove the skin. While this is uncommon, patients who have large amounts of upper arm fat and very loose skin require a more extensive surgery. By completing the procedure in this manner, patients who struggle with atypical amounts of fat/sagging can be left with a beautiful and elegant look.

Can an arm lift be performed under local anesthesia?

Yes! Arm lifts can be performed under local anesthesia. Patients assume this surgery can only be completed under general anesthesia, which deters some of them from surgery. General anesthesia does not work for everyone, especially patients who have heart disease, a history of stroke, suffer from extreme obesity (BMI > 30), or take blood-thinning medication. Hence, local anesthesia is a great option. Local anesthesia isn’t just for older patients; anyone may wish to avoid general anesthesia. Others may prefer to be asleep.

There is a much lower risk of anesthesia complications, no grogginess after surgery, no nausea, quicker recovery, and lower cost overall. There are always risks any time a patient goes under general anesthesia, and many of my patients opt for local anesthesia instead.

How does an arm lift work under local anesthesia?

The major difference between general and local anesthesia is that patients are fully awake, and the procedure is completed in my Tampa office instead of the surgery center. During an arm lift procedure, patients will be injected with local anesthesia in their upper arm area. Once the local anesthetic is injected, the tissue within the arm begins to swell and expand, making it easier for me to work with. From there, I can transition into the procedure with liposuction and the removal of sagging skin. Some patients like to take Valium prior to surgery to help relax, but once the arms are numbed no pain can be felt, only pressure.

The idea of being “awake” for surgery can be scary for many patients, but my surgical team and I make the process as smooth and seamless as possible. Many patients listen to music, audiobooks, or casually chat with our friendly surgical team while undergoing the procedure. Some patients even drift into a light sleep! After the surgery is complete, you can walk and even drive yourself home (only if narcotics were not taken).

What does recovery after an arm lift look like?

Since the body does not have to metabolize the anesthesia like it does under general, my patients have a quick and smooth recovery. They commonly report feeling sore, swollen, or a “tight” feeling for the first few days, which eventually subsides. I suggest over-the-counter pain medication to ease any of these pains, in addition to wearing the compression garments included in your surgical recovery pack. Patients can return to work in 3-7 days, resume light activity a few weeks after, and fully return to regular exercise at 6 weeks.

Your recovery doesn’t end when you leave the office. My team and I schedule regular follow-up visits to ensure each patient is healing properly, addressing any concerns they may have. During these appointments, we ensure patients feel completely taken care of, answering any questions, providing them with undivided attention, and as much reassurance as they need.

If you are interested in an arm lift in the Tampa area, please do not hesitate to contact our team to set up a complimentary phone call and consultation with Dr. Traci Temmen. We are here to help you look and feel like your best self! Our goal at Temmen Plastic Surgery is to not only enhance your natural beauty and create your most confident self but also make you a part of our family.