Arm lift surgery, or brachioplasty, removes the loose skin and fat under the upper arm after weight loss or with age, usually combined with liposuction, for a slimmer and firmer contour. The trade-off is a long scar, which we place along the inner back of the arm so it hides at rest and when the arm is raised. At Biruni Hospital in Istanbul, our plastic surgery team plans short, full or extended lifts, with a stay of seven to ten days.
About This Department
Plastic Surgery
Loose skin under the upper arm does not respond to exercise. An arm lift removes it, in exchange for a scar.
Arm lift surgery, brachioplasty, removes the hanging skin and fat on the underside of the upper arm and tightens what remains, leaving a slimmer, firmer contour from the armpit toward the elbow. It suits people after major weight loss, often following bariatric surgery, and those whose skin has loosened with age. The price comes in a long scar along the inner or back of the arm. A meta-analysis of 29 studies and 1,578 patients found thick or wide scarring in 9.9 percent, sagging again in 7.8 percent and a second operation for appearance in 7.5 percent (Aljerian and colleagues, Plastic and Reconstructive Surgery, 2022). Satisfaction remains high even so, and in a two-year study of patients after bariatric surgery, scores for arm appearance and for the scar itself rose significantly. This page explains the grades of arm laxity, who is suited, scar placement, the techniques from liposuction to extended arm lift, risks, the operation day, recovery, scar care, and how patients from abroad arrange brachioplasty at Biruni Hospital in Istanbul.
9.9
Percent of patients with thick or wide scarring, the most common problem across 1,578 arm lifts
7.5
Percent needing a second operation for appearance after brachioplasty
92
Percent rating results excellent or very good with a posteromedial scar, in one series of 90 patients
Free
Review of your photos and goals by our plastic surgery team
An arm lift trades loose skin for a scar. For the right patient, that trade feels worth it.
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The operation
The surgeon removes an ellipse of skin and fat from the underside of the upper arm, tightens the tissue and closes the wound in a line from the armpit toward the elbow. Liposuction usually shapes the arm in the same operation.
Loose skin on the arm often extends into the armpit and down the side of the chest. An extended arm lift carries the scar across the armpit to remove that excess too.
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Combined operations
An arm lift is often combined with a breast lift or thigh lift after weight loss, within safe limits of operating time.
Why exercise cannot fix it
Muscle cannot shrink skin.
Training the triceps builds muscle under the loose skin and can make a firm arm look better, but skin stretched by weight gain, by the loss of many kilograms or by age has lost elastic fibers that do not grow back, so the fold that swings when the arm moves stays however strong the arm becomes. Liposuction alone removes fat but leaves such skin hanging lower. Only removing the skin restores the contour.
Exercise still helps recovery.
Grades of arm laxity
Classification of upper arm laxity
Stage
Fat and skin
Usual treatment
1
Little fat, no sagging
Liposuction if needed
2a
Moderate fat, mild sagging
Liposuction, sometimes staged
2b
Much fat, moderate sagging
Liposuction with arm lift
3
Much fat, severe sagging
Liposuction with arm lift
4
Little fat, severe sagging
Arm lift
Why the stage matters
The El Khatib grading, based on the amount of fat and the degree of sagging, guides the choice between liposuction, a short-scar lift and a full arm lift (El Khatib, Plastic and Reconstructive Surgery, 2007). Patients with little fat and much loose skin gain most from excision, while those with good skin may need liposuction alone.
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The pinch test
We lift the arm to shoulder height and measure how far the skin hangs and how thick the fat is. Those two figures decide the plan.
Who is suited
1
Good candidates
Adults with loose upper arm skin after weight loss or ageing, at a stable weight, who accept a visible scar in exchange for a firmer arm.
Before an arm lift
Check
Target
Why
Weight
Stable for six to twelve months
Further loss loosens the skin again
Smoking
Stopped four weeks before and after
Wound healing
Nutrition after bariatric surgery
Protein, iron, vitamins checked
Healing depends on it
Lymphedema or arm swelling
Assessed beforehand
Surgery can worsen it
Scar history
Keloid tendency discussed
Scars on the arm show
Weight first
After bariatric surgery, we wait until weight has been stable for at least six months and blood tests show good nutrition.
People with a tendency to thick keloid scars, uncontrolled diabetes or poor circulation in the arms may be better served by other options, and we discuss those openly.
Where the scar lies
Scar positions in brachioplasty
Position
Where it lies
Trade-off
Medial
Along the inner arm, in the groove
Hidden with arms down, more complications in the meta-analysis
Posterior
Along the back of the arm
Easier access, visible from behind
Posteromedial
Between the two, slightly toward the back
Hidden with arms down and when raised
In a comparative series of 90 patients, 92 percent of those with a posteromedial scar rated results excellent or very good, against 72 percent with a medial scar and 58 percent with a posterior scar (Bruno and Calicchia, Aesthetic Plastic Surgery, 2025).
Outcomes by scar position, 90 patients
Position
Excellent or very good
Note
Posteromedial
92 percent
Wound separation 3 percent
Medial
72 percent
Groove position
Posterior
58 percent
Most visible
This was a single retrospective series, and results depend on each surgeon's experience with a technique. The meta-analysis also linked the medial incision with more complications (Aljerian and colleagues, 2022).
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Our approach
We place the scar in a posteromedial line in most patients, marked with you standing and your arms in several positions, so that it hides when the arm hangs and when it is raised.
The scar trade
The scar stays for life.
It starts red and raised, flattens over six to twelve months and becomes a pale line, wider in some people than others, and it will show in sleeveless clothes when the arm moves. People who hide their arms in long sleeves every summer because of the loose skin find that trade easy, while those with only a little laxity may prefer to live with it.
We show typical scars before you decide.
Techniques
Arm contouring options
Technique
Suited to
Scar
Liposuction alone
Fat with good skin
Tiny entry points
Short-scar arm lift
Laxity near the armpit only
Hidden in the armpit
Full arm lift
Laxity from armpit to elbow
Armpit toward elbow
Extended arm lift
Laxity into the side of the chest
Arm, armpit and chest wall
Adding liposuction to excision lowered some complications in the meta-analysis, since it thins the tissue before removal and spares lymph channels.
Liposuction-assisted brachioplasty removes fat first and then lifts the loosened skin away while leaving the deeper lymph channels and nerves in place. We use it in most arm lifts.
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Z-plasty in the armpit
A small zigzag where the scar crosses the armpit prevents a tight band that would limit raising the arm.
Arms after major weight loss
After losing 40 or 50 kilograms, the arm skin often hangs well below the elbow line when the arm is raised, and the looseness continues onto the chest wall. An extended arm lift treats both.
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Staging
Arm lift, breast surgery, tummy tuck and thigh lift are usually spread over two or three operations several months apart, to limit operating time and risk.
Our mommy makeover and tummy tuck pages describe how we combine and stage body contouring safely.
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Nutrition
Protein and iron deficiency slow healing after bariatric surgery, so we check blood tests and correct any shortfall before operating.
Risks
Swelling and bruising of the arms for several weeks.
Tightness when raising the arms, easing over weeks.
Numbness near the scar, improving over months.
Complications in 1,578 patients
Pooled complication rates after brachioplasty
Complication
Rate
Management
Thick or wide scar
9.9 percent
Silicone, steroid injection, scar revision
Sagging again
7.8 percent
Revision
Wound separation
6.8 percent
Dressings
Seroma, fluid collection
5.9 percent
Needle drainage
Infection
3.6 percent
Antibiotics
Nerve symptoms
2.5 percent
Recover in most over months
Lymphedema or lymph collection
2.5 percent
Compression, drainage
Operations to improve appearance followed in 7.5 percent of patients, and operations for medical problems in 1.6 percent (Aljerian and colleagues, 2022).
Satisfaction despite long scars
Long scars rarely spoil the result.
An Italian study followed 68 patients who had an arm lift after bariatric surgery for at least two years, using validated questionnaires on arm appearance and on scars, and every score rose significantly from before surgery, with patients reporting that solving daily problems caused by the excess skin, from clothing to hygiene, outweighed their concern about the scar (Barone and colleagues, Aesthetic Plastic Surgery, 2025).
Expectations were clear beforehand. That matters.
Lymph and nerves
Protecting the lymph channels
Lymph channels drain fluid from the hand and forearm along the inner arm. Keeping the removal shallow and using liposuction to separate tissue protect them. Persistent swelling of the forearm or hand after surgery needs early review and compression.
Can an arm lift damage nerves?
A small skin nerve, the medial antebrachial cutaneous nerve, runs close to the inner arm and supplies feeling to the forearm. Careful dissection preserves it, and numbness or tingling in the forearm, reported in about 2.5 percent of patients, improves over months in most. Weakness of the hand or arm is not expected.
Early warning signs
Increasing swelling of the hand, fever, or a hot, red arm need a call to the team the same day.
The operation day
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Marking
We mark the arms with you standing, arms at your sides, raised and bent, and photograph them.
Operation day timeline
Step
Timing
Note
Marking
Morning
Several arm positions
Surgery
Two to three hours
General anesthesia
Recovery room
One to two hours
Arms raised on pillows
Ward
One night
Compression sleeves fitted
Dissolving stitches close the wound under the skin. Drains are used only after large excisions and come out within a few days.
Pain
2
Pain relief
Soreness and tightness settle with regular painkillers over the first days, and local anesthetic along the wounds reduces pain on waking.
Recovery
Wear compression sleeves day and night for four to six weeks, keep the arms raised on pillows when resting, and avoid lifting anything heavier than a cup for two weeks.
Recovery after brachioplasty
Time
What happens
Activity
Days 1 to 3
Swelling, tightness
Light daily tasks, arms supported
Week 1
Wound check
Showering, desk work
Weeks 2 to 3
Swelling lessens
Driving, light lifting
Week 6
Wounds strong
Gym, lifting, swimming
Months 6 to 12
Scar matures
Final result
Scar care and results
Caring for the scar
1
The first year
Silicone gel or tape for three to six months, sun protection on the scar for a year, and gentle massage once wounds heal help the scar flatten and fade.
The contour shows within weeks, and swelling settles over three months. The result lasts as long as weight stays stable, although ageing continues to loosen skin slowly.
For patients from abroad
Plan for seven to ten days in Istanbul. The wound check before your flight home confirms healing is on track.
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What to send
Photographs of both arms from the front and back, hanging and raised to shoulder height, your height, weight and weight history, bariatric surgery details and recent blood tests.
After you return home, follow-up continues by video at one, three, six and twelve months, and a local doctor or nurse can check the wounds. Wear the compression sleeves and move the arms during the flight.
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Combined plans
An arm lift combined with breast or thigh surgery may extend the stay by a few days.
One coordinator from the international patients office handles arrangements from the first message through discharge and answers the same WhatsApp number after you return. The office works in English, Arabic, French, Russian, Serbian, Romanian and Spanish and books interpreters for other languages, and it arranges the visa invitation letter, airport transfers, daily transport and accommodation near the hospital. Halal, vegetarian and diabetic meals, a prayer room on site, and a female physician on request wherever the rota allows.
A typical stay
Day
Step
Note
Day 1
Consultation, tests, marking
Plan agreed
Day 2
Surgery
One night in hospital
Days 3 to 6
Rest at the hotel
Check visit on day 3
Day 7 to 10
Wound check
Cleared for travel
Cost
The price depends on whether the lift is short, full or extended, on added liposuction and on combined operations.
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Our quote
We quote after reviewing your photographs, before you travel.
A quote covers the surgeon, anesthesia, operating room, one night in hospital, compression sleeves, medicines and video follow-up for a year.
What a quote for brachioplasty covers
Item
Included
Priced separately
Surgery
Arm lift with liposuction
Combined breast or thigh surgery
Hospital
One night
Extra nights
Aftercare
Compression sleeves, scar silicone, video follow-up
Scar revision
Compare quotes for the same technique and scar length, and ask whether liposuction and the extended lift into the chest are included.
Cheaper quotes sometimes treat the arm alone and leave the chest wall untouched.
References
Aljerian A, Abi-Rafeh J, Ramirez-GarciaLuna J, Hemmerling T, Gilardino MS. Complications in brachioplasty. A systematic review and meta-analysis. Plast Reconstr Surg. 2022;149(1):83-95.
El Khatib HA. Classification of brachial ptosis. Strategy for treatment. Plast Reconstr Surg. 2007;119(4):1337-1342.
Bruno A, Calicchia A. A comparative analysis of functional and aesthetic outcomes in brachioplasty techniques. Posterior, medial, and postero-medial approaches. Aesthetic Plast Surg. 2025;49(20):5794-5808.
Barone M, Salzillo R, Amenta A, Brunetti B, Tenna S, Persichetti P. Balancing aesthetics and scarring. Insights from post-bariatric brachioplasty. Aesthetic Plast Surg. 2025;49(16):4664-4670.
Editor's note
Written by the Biruni Hospital medical editorial team. Reviewed by Assoc. Prof. Dr. Fatih CERAN, Plastic, Reconstructive and Aesthetic Surgery.
