October 2017 Aesthetic Surgery Journal had a great article about “Lymphatic and Sensory Function of the Upper Limb After Brachioplasty in Post Bariatric Massive Weight Loss Patients.”
So the question is, does doing an arm lift cause issues with nerve sensation change? Does it cause issues with lymphatic drainage (which could cause swelling of the arm)?
Their study: Their arm lift technique is a double ellipse marking, medial incision, superficial undermining, and posterior arm liposuction. They undermine just under the skin surface, and only dissect theskin they are removing. They did this prospective study on 12 women who had brachioplasty after massive weight loss. They evaluated the lymphatic drainage by volumetry of the forearm and indocyanine green lymphography of the entire limb. Sensation was tested by Semmes Weinstein monofilaments in eight spots to test sensation in all of the different arm skin nerves. They were followed for one year.
Results:
- Complications: one dehiscence, and two elevated scars
- Sensation was unchanged after surgery
- Lymphography showed normal patterns, and forearm volume was unchanged.
So?
This technique does not cause sensation or lymphatic changes. They did this study because the number of brachioplasty surgeries has increased during the last 20 years, but complication rates remain high. 25-40% of patients have adverse effects from arm lifts. A major challenge is where to place the scar and how can we make the scar be pretty (Arm lift scars frequently pigment, elevate, or widen). They advocate for the medially placed scar to help preserve sensation. They cite studies which show the safety of liposuction at the time of brachioplasty, but advocate keeping the liposuction in a different area than the skin removal (so the excision is medial, and the liposuction is posterior).