In the Media

PLASTIC SURGERY UPDATE: ARMLIFTS

By Dr. Steven Bloch, M.D.

Women often hate their underarms. It seems that no amount of diet or exercise will correct the loose, flabby skin of the underarm. Often, the patient is in otherwise excellent shape. Skin creams just won't do it.

In the past, the only remedy was to excise the excess skin and fat. Unfortunately, this left a significant scar that ran down the inner aspect of the arm from the armpit to the elbow which often did not heal well. This is still an acceptable procedure, but for the most part, is now reserved for very extreme cases.

With advanced technologies and improved surgical techniques, scars can be significantly reduced and in many cases eliminated. Non-invasive techniques now improve the appearance of the underarms. These technologies involve the use of either radio frequency waves or infrared waves. Basically, this energy is applied externally and penetrates either into the fat to cause a shrinkage of the fat cells or into the deeper layers of the skin to promote collagen shrinkage and thereby tightening of the skin. The results can often be quite dramatic and there is no downtime.

Slightly more invasive is laser liposuction. Laser liposuction has the advantage over traditional liposuction in that it not only melts the fat, but it heats up the collagen and promotes skin tightening. With traditional liposuction, not only is skin tightening not achieved but skin laxity can be aggravated. With this procedure, there are no scars, recovery is usually quick, and patients can resume normal activities in days.

In more extreme cases, the arm can be lifted by placing the scar in the armpit. This has become a very popular procedure over the last several years. Advantages are that the scar is hidden in the armpit and it allows you to comfortably wear sleeveless tops. The downtime is a little bit longer and it takes a while for the scar to flatten down and fade. Results are usually excellent.

The interesting thing to think about is that all of these technologies can often be combined to achieve an even better result. With the use of laser lipo and non-invasive techniques, often the more extreme cases that would require a long incision running down the inner aspect of the arm can be converted to the much shorter armpit lift. Likewise, the armpit candidate may be converted to just laser lipo. There are endless variations.

Another recent improvement is Fraxel CO2. This unique laser can safely be used on the underarms to change the appearance of the skin texture or so-called "chicken skin." Patients should realize that the point of a consultation is to determine which technique and technology is right for them. Obviously, what also has to be considered is the amount of time involved with each technology and cost.