Arm Lift

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Before the Surgery:

+ What is an ARM LIPECTOMY?

This is a surgical operation to improve the appearance and contour of the upper arm by removing fat and skin from the upper inside part of the arm, from the elbow region to the axilla (arm pit).

It is also referred to as a BRACHIOPLASTY.

It is sometimes referred to as a Bat Wing Deformity.

+ Who can have this operation?

The typical patient who is a candidate for an arm lipectomy procedure has excess skin or skin and fat over the upper arm area that has not responded to weight loss and/or exercise.

This is common in patients with significant weight loss or in patients that have inherited a predisposition to accumulate excess fat in the upper arm area.

This applies to both men and women.

+ Why does excess fat accumulate in the upper arm area?

Patients distribute excess fat differently.

The typical fat distribution in women and in some men is peripheral. This means the excess fat can occur in the layer between the skin and the arm muscles.

Excess hanging skin can develop in the upper arm area if the patient has lost a large amount of weight. Patients who have undergone bariatric surgery with a large amount of weight loss, or patients who have lost a large amount of weight through a life style change in diet and exercise may develop this hanging skin.

There often is varying amounts of fat within this hanging skin pannus.

There may be no excess skin but just excess fat which creates a large heavy upper arm.

The pannus does not involve the muscle of the upper arm and therefore exercise will not improve or eliminate the arm pannus.

+ When can an Arm Lipectomy be done?

The timing for an arm lipectomy procedure is most often planned after the patient’s weight is stable.

Patients have often unsuccessfully tried to improve the arm contour with exercise.

Dr. Giuffre advises that the patient comes into the arm lipectomy surgery at a weight that is a “no brainer weight”: a weight that is stable that the patient has maintained for months or years based on their current life style,

Then there will be no extra ordinary effort for the patient to maintain this weight after surgery. The surgical result with then be maintained without changing the patient’s life style.

+ What if I lose weight after surgery?

Weight loss after arm lipectomy surgery will not affect the result of the arm lift surgery but will reduce other areas of body fat over the hips, arms, buttocks etc.

Postoperatively, a change in life style to permanently lose weight will not affect the result of the arm lipectomy surgery.

+ Am I a candidate for an ARM LIPOSUCTION without removing skin?

Arm liposuction is a procedure designed to correct the arm contour by removing only fat from the upper arm area without disturbing the skin.

This procedure is reserved for patients with heavy upper arms with a fairly tight skin envelope (no excess hanging skin).

After the excess fat is removed with a liposuction technique, the skin must have enough elasticity and recoil to shrink around the smaller arm.

This procedure is typically reserved for a younger patient population.

In the consultation with Dr. Giuffre, the arm lipectomy versus the arm liposuction options will be discussed.

+ Can this procedure be used for massive weight loss patients?

A large amount of weight loss can produce excess skin in all areas of the body that have lost a considerable volume of tissue.

This includes the arms. It also occurs in the breast, abdomen, hips, flanks, buttocks and legs.

+ Is Arm Lipectomy surgery covered by AHS (Alberta Health Care) if I get a referral from by GP?

The arm lipectomy, or arm liposuction procedures, are considered a cosmetic procedure by AHS, and are therefore not covered even with a referral from the Family Physician.

+ I am a massive weight loss patient. Can I have an Arm Lipectomy and is it covered by AHS (Alberta Health Care)?

The arm lipectomy or arm liposuction procedures are considered a cosmetic procedure by AHS and are therefore not covered even with a referral from the Family Physician.

Surgery should be deferred until the weight loss has stabilized.

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The Operation:

*Please tap here to visit www.pclsc.ca under headings ARM LIPECTOMY or BRACHIOPLASTY in the menu.

+ Do I have to go to sleep (General Anesthesia) to have a Brachioplasty?

A General Anaesthetic is required in all cases.

+ How long does the operation last?

Approximately an hour and one half to two hours.

+ Where is the surgery done?

Dr Giuffre uses a private surgical suite adjacent to his Meadowlark Health Centre Office(#176) for his cosmetic procedures.

Please tap here to visit https://www.meadowlarksurgicalcosmetic.com

+ Where is the incision for the Arm Lipectomy?

The incision design will depend on the size and length of the arm pannus.

It can extend from just below the elbow area to the axilla (arm pit) on the inside of the upper arm.

*For ARM LIPOSUCTION please see FAQ Arm Liposuction

+ Will there be a scar?

Yes. Any incision in the skin, regardless of where in the body will heal with a scar. The scar will mature (the scar colour goes from red, to pink, to white, and the scar softens and becomes pliable) which can take 1-2 years. Medical paper tape placed directly over the incision and changed weekly for 3 months will help speed up the process of scar maturation.

+ Will I have stitches?

Yes. They are under the skin and absorb (disappear by themselves) therefore, there are no sutures removed.

In very heavy arms, the additional use of surgical staples to reinforce the incisions may be used. These are removed within 5-6 days after surgery.

+ What happens surgically in an Arm Lipectomy?

Before the surgery, with the patient standing, the surgical plan is made by drawing on the upper arms. The amount of skin and fat excision is planned.

A photo graph is taken. The patient will receive a copy of the preoperative photograph at the 6 week check with Dr. Giuffre

Once the patient is asleep (General Anaesthetic), the incisions are made.

The excess skin and fat is removed; the muscles are left undisturbed.

The incisions are then closed with self-dissolving stitching under the skin.

A drainage tube may be place in the surgery site but this is uncommon.

+ What happens after my surgery?

You will have a firm tensor bandage-like binder dressing on for the first day after surgery.

You will be seen the next day after surgery, where all of the dressings will be removed.

You may then shower. No further dressings are required.

You are discouraged from having a bath, hot tub, or swimming for 6 weeks following surgery.

You are encouraged to walk the day of surgery to avoid the risk of blood clots in your legs (during the surgery you will have had special sequential stocking on your legs that maintains normal leg circulation).

If there is a drainage tube, it will be removed when the drainage is 25 cc’s in 24 hours for a day or two.

You are encouraged to use the arms in regular light daily living tasks.

Arrangements will be made to see Dr. Giuffre at 6 weeks postoperatively.

+ Is the Arm Lipectomy procedure painful?

Before waking from the surgery, Dr. Giuffre will inject a long acting local anesthetic into the arm area to decrease any immediate arm discomfort from the surgery.

When the freezing wears off, the patient will require postoperative analgesic medication (pain killers) for up to a week. The discomfort typically subsides after the first two to three days following the surgery.

*Patients taking prescription pain killers should not drive a car or operate machinery or sign significant documents while taking this medication.

+ Do I go home the same day as Surgery?

Yes. You will have to arrange a ride and aftercare with a responsible adult.

You are not permitted to leave unaccompanied or in a taxi.

+ I live out of town. Should I stay overnight?

If your driving distance from Edmonton exceeds 90 minutes, you should make arrangements to stay overnight in Edmonton. The surgical centre does not have an overnight care facility. You will then be seen the following day for dressing removal and assessment by Dr. Giuffre and his staff.

+ Can I contact my surgeon the day or night of surgery if I have a concern?

Yes, Dr. Giuffre provides his home phone number to his cosmetic patients in case there is a patient concern.

In the rare instance that a patient requires hospitalization, Dr. Giuffre has admitting privileges to all the major hospitals in Edmonton.

+ When do I see my surgeon after surgery?

You will be seen:

  • The day following surgery by Dr. Giuffre and/or his nursing staff.
  • You will be seen again within the week following your surgery by Dr. Giuffre.
  • Further follow up arrangements will be made at that time.
    + When can I shower?
    A shower is okay after the first dressing change, which is usually done the next day after surgery. It is okay to get the incision wet from a shower, but Dr. Giuffre recommends that you avoid a hot tub or bath, swimming pools or lake and ocean swimming for 6 weeks following surgery.
    + In what position can I sleep?
    In any position that is comfortable.
    + When can I resume relations with my partner?
    6 weeks is recommended.
    + What should I do to minimize scarring?
    Vitamin E oil and Bio oil are not proven to positively impact scar healing. Dr. Giuffre recommends placing medical paper tape on the incision for 3 months, changed weekly by the patient.
    + How long should I plan to be off work?
    The typical time off work is two weeks. If your work is extremely strenuous and involves heavy lifting, the time off work will be longer.
    + How long am I off sports and my workouts?
    No sports or strenuous activity is permitted for 6 weeks. Patients are to avoid strenuous activity that increases their heart rate and blood pressure. This could produce bleeding inside the surgical site. The rule of thumb is, if you are sweating from the activity, you are over doing it and you are placing yourself at risk.
    + What about eating and drinking after my arm lipectomy?
    Regular food and beverage consumption, as the patient did preoperatively, is recommended.
    + Are there before and after pictures?
    Yes. Every patient that Dr. Giuffre operates on for cosmetic reasons will have a preoperative photograph taken. At the 6 week check up with Dr. Giuffre, his patients are given an 8 x 10 preoperative photograph.

Postoperative photos are also taken in some instances.

The Risks:

+ What are the risks of doing an Arm Lipectomy procedure?

With any surgery there are surgical and anesthetic risks.

Aside from the rare risks of an anesthetic event, some of the general and specific surgical risks for this procedure would include:

  • Scarring
  • Infection
  • Swelling and bruising
  • Sensation change to the upper inner arm and axilla for up to 3-6months
  • Numbness to the hand in the first week
  • Discomfort
  • Time off work and exercise
  • Bleeding (hematoma)
  • Seroma (fluid collection in the operative site)
  • Tissue loss in patients that smoke
  • Contour asymmetry

This list is not complete.

During the consultation with the patient, Dr. Giuffre will outline and explain each of the risks in detail.

The Followup:

+ How often do I need to come back for a checkup after the surgery?

Postoperative visits include:

  • A 24 hour visit
  • A 1 week visit
  • Often a 2 week visit
  • A 6 week visit

If there are any patient concerns, Dr. Giuffre provides his home phone number for patient's direct access.

After the 6 week visit, if there are any future requests for an appointment, they are made directly with Dr. Giuffre office and an expedited visit is arranged.

+ I no longer have access to my original surgeon. What can I do?

For cosmetic or reconstructive concerns, patients are invited to contact Dr. Giuffre's office (780-428-7737) for an appointment. He does not require a referral.

There is no charge for the consultation.

+ I had an Arm Lipectomy with another surgeon and I am unhappy. What can I do?

It is always wise to re-consult with your original surgeon in order that he can assess you and your concerns. If that fails or you are still unhappy with your options, you can always seek a second opinion. Dr. Giuffre would communicate your concerns with your original surgeon in order to facilitate a resolution.

+ I had an Arm Lipectomy in another country. I have a problem. What can I do?

For cosmetic or reconstructive concerns, patients are invited to contact Dr. Giuffre's office (780-428-7737) for an appointment. He does not require a referral and there is no charge for the consultation.

+ I had an Arm Lipectomy years ago. I have gained weight and I am unhappy with my result and scars. What can I do?

This can happen from weight change, aging, and menopause. A consultation with Dr. Giuffre is recommended to review the cause and options for improvement.

Financing:

+ Can I finance the costs of the surgery? How do I do this?

Dr. Giuffre does not provide in house financing for cosmetic procedures.

There are a number of companies across Canada that will finance cosmetic surgery similar to car financing or mortgages. Please refer to the links provided on the Home Page for this information.

Dr. Giuffre has no financial or business relationship or affiliation with any of these companies.

+ If something goes wrong, do I have to repay for the operation?

You do not have to pay for the treatment of an immediate complication. In the unusual event that there is a problem with your original surgery, you do not have to pay for the correction.

+ How much does it cost?

The cost of cosmetic surgery is covered entirely by the patient. The one fee would include:

  • the cost of the anesthetist (who provides the General Anesthetic)
  • the rental of the operating room and equipment
  • the rental of the recovery room and equipment
  • the staff including the nurses and administration staff
  • the surgical fee

The cost will vary depending on, the duration of the procedure, and the quality and sophistication of the surgical facility where the surgery is performed.

The fees will be discussed at the time of consultation with Dr. Giuffre.

There is no obligation to proceed with surgery following the consultation. The patient is referred to our web sites and is invited back for a second consultation if need be.

Our office will endeavour to expedite a surgical procedure to accommodate both business and family obligations. All fees are receipted. GST payment is required.

+ What about having my Cosmetic Surgery in another country where it is cheaper?

There is a current trend to have surgery out of your country, where the surgery may be cheaper.

We call this “tourist surgery”.

There are a number of additional risks to do this which include:

The Surgical skill, experience, licensing and education of an unknown surgeon.

Canada has very strict rules and requirements to be a licensed Plastic Surgeon (FRCS(C)) in our country.

Your Plastic Surgeon has completed an undergraduate degree (4 years), an MD degree (4 years), a Fellowship Degree in Plastic Surgery (5 years) and often a post Fellowship (1-2 years).

  • A “friend” is not a good reference. Nor is glitzy advertising.
  • The Safety, sterility and equipment quality including anaesthesia machines in the hospital or private surgical Suite; this may lead to increase infection and anaesthetic risks
  • Post op care is limited to the time you spend in their country.
  • If you have a complication, to see your original surgeon, you will have to fly back or see a new surgeon in your own Country.
  • If you have an unsatisfactory result, you will have to fly back to see your original surgeon or find a new Surgeon.
  • The cost of the repair may exceed what you originally paid and the final result fixing a mistake is often not as good as it could have been had the surgery been done correctly the first time.

After accounting for the accumulated costs of the air travel, hotel, surgery and postoperative care, the perceived cost savings may not be significant.

If you have a severe, life threatening complication, Alberta Health Care will cover the medical costs for your care.

Correcting the reconstructive problem as a result of the complication would be the patient’s financial responsibility.

 
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Life is full of choices; your character reflects those choices.
— Dr. M.J. Giuffre

Licensed in Edmonton + Alberta

Find your best self.