A brachioplasty, commonly called an arm lift, is a surgical procedure that removes excess skin and fat from the upper arms to create a smoother, more toned contour. It’s most often sought by people who have loose, hanging skin after major weight loss or as a result of aging, where the skin has lost its elasticity and no longer responds to exercise.
Who Is a Good Candidate
The best candidates are people who have reached a stable weight and are bothered by sagging skin on their upper arms that doesn’t improve with strength training. This is especially common after bariatric surgery or significant weight loss, where the skin stretched beyond its ability to snap back.
If you’ve had weight loss surgery, most surgeons want you to wait at least 12 months after the procedure and hold your weight steady (within about 11 pounds of your goal) for three to six months, ideally a full year. A BMI under 30 is generally preferred, though patients with a higher BMI may still be considered if other health conditions are well managed. Active smoking, unstable weight, and poorly controlled diabetes or heart disease all increase surgical risk and may delay or disqualify you from the procedure.
Types of Brachioplasty
There are three main variations, and which one fits depends on how much excess skin you have and where it’s located.
- Mini brachioplasty (short scar): Uses a small incision hidden in the armpit. It works well for mild sagging, often from aging or minor weight changes, but it can’t address large amounts of loose skin.
- Standard brachioplasty: The most common version. The incision runs from near the elbow up to the armpit along the inner arm, allowing the surgeon to remove a significant amount of skin and fat. The scar is placed toward the back of the inner arm so it’s less visible when your arms hang at your sides.
- Extended brachioplasty: Designed for people who’ve lost a substantial amount of weight. The incision starts at the elbow, runs through the armpit, and continues onto the side of the chest wall. This addresses sagging that extends beyond the arm itself.
What Happens During Surgery
Arm lifts are typically performed under general anesthesia. The surgeon marks the planned incision lines while you’re standing, since gravity changes the way skin hangs compared to lying down. Once you’re under anesthesia, the surgeon makes the incision along the inner arm, removes the excess skin and underlying fat, and tightens the remaining tissue before closing the incision in layers. The whole procedure usually takes one to three hours depending on the technique.
Recovery Timeline
The first week is the most restrictive. Walking is encouraged right away, but you’ll need to keep your arms relatively still and avoid lifting anything heavy. Dressings and wraps typically come off at your first follow-up visit, around five days after surgery. At that point you can shower, pat your incisions dry, and start wearing a compression garment on your arms.
For the first four weeks, avoid any exercise that directly stresses your upper arms. After a month, light cardio like stationary cycling or brisk walking is generally safe. Heavy lifting, jogging, and contact sports should wait a full six weeks. By that point, most people can return to their normal activity level.
Scarring: What to Expect
Scarring is the most visible tradeoff of brachioplasty. Every arm lift leaves a scar, and with the standard technique, it runs along much of the inner arm. In the early weeks, scars tend to look red, raised, and firm. Over 12 to 18 months they gradually flatten, lighten in color, and become less noticeable, but they never disappear entirely.
There’s a lot you can do to help that process along. Once your incisions have fully closed (usually two to three weeks after surgery), gentle scar massage with a moisturizer two to three times daily can break down dense tissue and promote a smoother result. Silicone gel sheets or silicone-based creams are clinically shown to reduce scar thickness and color. Protecting scars from sun exposure for the first 12 to 18 months is important: cover your arms with clothing or use a broad-spectrum SPF 30 or higher sunscreen once your surgeon gives the go-ahead for topical products.
If a scar remains thick or prominent after it matures, options like laser therapy, microneedling, or steroid injections can further improve its appearance.
Risks and Complications
A large literature review found that about 29% of brachioplasty patients experienced some type of complication. That number sounds high, but the most common issue was hypertrophic scarring (raised, thickened scars), which affected roughly 11% of patients. That’s a cosmetic concern rather than a medical emergency.
Other complications by frequency: fluid collection under the skin (seroma) occurred in about 7% of patients, delayed wound healing or wound separation in about 6%, infection in about 3%, and significant bleeding (hematoma) in less than 1%. Most of these resolve with conservative treatment, though some may require a follow-up procedure to drain fluid or re-close a wound.
How Long Results Last
Results are long-lasting as long as your weight stays stable. The removed skin and fat don’t grow back. However, your arms will continue to age naturally, and significant weight gain or loss can stretch the remaining skin and bring back some degree of sagging. Maintaining a steady weight after surgery is the single biggest factor in preserving your results over the long term.
Cost
The average surgeon’s fee for a brachioplasty is $6,192, according to the American Society of Plastic Surgeons. That figure covers only the surgeon’s time. The total bill also includes anesthesia, the operating facility, medical tests, compression garments, and prescriptions, which can add several thousand dollars depending on your location and the complexity of your procedure. Most insurance plans classify brachioplasty as cosmetic and don’t cover it, though exceptions sometimes apply when excess skin causes documented medical issues like chronic rashes or infections.