An arm lift refers to procedures which remove areas of skin and fat from the upper arms in patients who may or may not be massive weight loss (MWL) patients.  In the non-MWL patient, the procedure is used only in cases of fairly significant skin excess, because the scar is not always favorable.  In the non-MWL patient with mainly fat excess, sometimes liposuction alone can achieve a significant improvement.

In the MWL patient, if the arms still contain significant fat, then two operations are required: first, aggressive liposuction of the arms to deflate them; and second, the actual arm lift (brachioplasty).  In MWL patients whose arms are already deflated with only skin excess remaining, only one operation - the brachioplasty - is required.

There are many techniques for brachioplasty, including elliptical excision, T-incisions, a z-type modification, and an L-shaped technique.  I have experience with all of these techniques, and I strongly prefer the L-shaped technique which I learned from Dr. Hurwitz in Pittsburgh.  There is usually no way of avoiding a scar that goes at least down to the elbow, and sometimes further down the forearm.  Also, we extend the incision onto the chest wall (the second part of the L), because the skin deformity extends into the chest wall.  Procedures that do not extend onto the chest wall rarely achieve a good result in the MWL patient.  This video shows the L-brachioplasty technique done here at BIDMC (note: graphic content):