Brachioplasty (Arm Lift or Bingo Wing Correction)

As we age, or after losing a lot of weight, it is common to develop an overhang of skin from the upper arms.

Unfortunately no amount of exercise can improve the loose skin and this “bat wing” appearance can only be removed through surgical excision.

Any excess skin and fat is removed from the upper arm in one of two ways, depending on your needs and scar preference. Liposuction is used to establish a tissue plane and remove any excess fat. If you have minimal excess, then a small horizontal incision can be hidden in the armpit. This only allows small tuck with a moderate improvement in shape. The scar can be seen but only on very close inspection.

For those who wish a more significant improvement, then a longitudinal scar from armpit to elbow is required. The scar is placed so that it will not be visible when your arms are by your side. This allows a large amount of excess skin to be removed, with the inevitable trade off of a scar.

Occasionally patients have excess skin that extends to the forearm for a variable degree. This is removed through a continuation of the upper arm scar down the medial side of the arm. The scars heal well and fade with time. They will, however, always be detectable and have a tendency to stretch. The wounds are closed with dissolvable sutures that do not need to be removed. A waterproof glue dressing is applied which means you do not need dressings and can shower immediately.

The surgery takes between two and three hours to complete and is usually performed under a general anaesthetic (you will be asleep during the procedure).

The operated area and hands may be swollen for a few days to weeks and you will experience some pain. Simple painkillers are all that is normally required, although aspirin should be avoided for the first few weeks following your operation.

Providing all is well, you can expect to go home the day after surgery.

Having cosmetic surgery can be a very positive experience. Complications are infrequent and usually minor. However, no surgery is without risk and it is important that you are aware of possible complications.

Scar – scars tend to settle remarkably well, however some people heal with thick scars and this can make them more noticeable.

Bruising and swelling – bruising and swelling is very common and may take several weeks to settle. It is very unlikely that swelling will persist long term.

Haematoma – this can happen if a bleed occurs under the skin, allowing a large blood clot to form. If this does occur, it is likely to happen within four to six hours of surgery. Any increase in swelling or pain should be reported immediately so that treatment can be given. Sometimes patients need to have this blood removed with another short operation.

Infection – this is rare but you may require antibiotics if there are any concerns.

Wound healing problems – this problem is rare but can happen if the skin is under tension. These healing difficulties can range from minor problems, such as small areas of wound separation, to major issues, such as skin loss. Although very rare, this situation may require a skin graft to close the wound, meaning more surgery. People who have diabetes, smoke, are obese or elderly are at an increased risk of delayed healing.

Numbness, reduced sensation or oversensitivity – this can occur around the arm. This is usually temporary, but occasionally these changes can remain to some degree.

DVT/PE – following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and move to your lungs. If the blood clot is large enough it could prove fatal. In order to reduce any risks of this we give you special stockings to wear in bed and a blood thinning injection if you are not mobile.

Asymmetry/shape irregularities – these can occur following this operation. In rare cases, further surgery is needed to correct this.

All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to contact me. Decisions about cosmetic surgery should never be rushed.

You will have a compression dressing put on in theatre. You will be advised to wear the compression dressing day and night for the next four weeks to give support and prevent bruising or fluid collecting.

Before you leave the hospital, you will be given a follow up appointment to see the nurses in dressing clinic after a week. This is to check your wounds and progress. I will normally see you at about 4 weeks or sooner if you have any problems.

Recovery times vary from one person to another but most patients will take 2 weeks off work. You can drive from 2 weeks and return to full activities at 4 weeks. If you have any concerns during this period, do contact the hospital team for advice.

Anne Dancey

I hope you find this information useful. If you have any questions or require a little more information then please do not hesitate to contact me.

Anne Dancey

Plastic and Reconstructive Surgeon FRCS(Plast), MBChB(Hons), MMedSci(Hons) and MCh(PASP)