Liposuction-Assisted Posterior Brachioplasty: Technical Refinements in Upper Arm Contouring

Background: Brachioplasty has increased 4059 percent from 2000 to 2008 in the United States, with 14,059 upper arm lift procedures performed in 2008. Numerous variations in the evolution of brachioplasty have been described to improve on complications and outcomes. Liposuction-assisted posterior brachioplasty is the next step in the series of refinements in upper arm contouring. Methods: The authors present a series of 21 patients who underwent upper arm contouring with liposuction-assisted posterior brachioplasty, and include an operative video detailing the enhancements. After anatomical analysis of the posterior arm, noting skin and fat redundancy, appropriate patients were selected for this procedure. Operative markings, liposuction technique, and the unique excisional technique are presented with intraoperative video footage. Results: Patients tolerate liposuction-assisted posterior brachioplasty very well, with minimal complications and good results. One post–bariatric surgery patient experienced a small wound dehiscence, and one non–bariatric surgery patient developed a slight hypertrophic scar in one arm. No other complications were noted. No revisions were performed. Conclusions: Liposuction-assisted posterior brachioplasty is an efficient and reproducible procedure in selected patients with generalized inferior arm skin and fat redundancy. It simplifies the markings and resection. It provides a safe procedure by preserving lymphatics, blood loss, and nerves. It produces reliable and predictable results with optimal outcomes. This technique offers another refinement in the evolution of upper arm contouring.