Showing posts with label brachioplasty. Show all posts
Showing posts with label brachioplasty. Show all posts

Tuesday, May 22, 2018

Armpit Rolls and Tail of the Breast

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Armpit Rolls
Armpit rolls are folds of skin and fat that lie at the upper front edge of the armpit. They make some women self conscious about wearing spaghetti strap tops or strapless dresses and bras. Their presence can be independent of breast size or patient weight
armpit rolls are independent of breast size
Armpit Rolls Are Independent of Breast Size as Seen Before and After Breast Reduction Surgery

and they can be asymmetric in size or even absent on one side.
armpit rolls can be asymmetric
Armpit Rolls Can be Present on Only One Side
In older individuals they can deflate leaving just a fold of excess skin.
deflated armpit roll
Deflated Left Armpit Fold in Older Patient

They are composed of a variable combination of skin, fat and glandular breast tissue. Their removal by liposuction is a common part of breast reduction surgery where they are mostly composed of fat rather than glandular breast tissue. When looking at before and after breast reduction photos they may be more visible on side views. Ignoring them in breast reduction surgery yields a less than optimal result. In massive weight loss patients the skin component is much larger and in most cases some removal of the excess skin is required. The surgical modalities employed therefore depend on contents of the roll. As mentioned most patients do well with just liposuction or even non-surgical fat removal by injection, freezing etc.. If the roll is mostly glandular direct excision via an armpit incision is the best option. In cases where the pinch thickness of the roll is minimal or there is still a visible roll after liposuction or direct excision the skin is removed as it would be in an arm lift described in my previous blog Upper Arm Lift - Brachioplasty. The upper arm lift is composed of an inner upper arm segment and when necessary armpit and side of chest extensions. In the case of armpit rolls only the armpit extension would be required i.e. armpit portion of an L-lift brachioplasty with or without z-plasties hiding the scar in the armpit behind the muscle.
armpit section of upper arm lift
Armpit Section of Upper Arm Lift

Depending on the individual case this could be performed under local anesthetic.

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Upper Arm Lift - Brachioplasty

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Friday, May 3, 2013

Brachioplasty - Upper Arm Lift

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Upper arm fat and skin removal to reduce hanging upper arm skin in obese women was first described in 1930. Cosmetic brachioplasty or upper arm lifts were first described by Argentinian surgeons in 1954 and subsequently became a well established procedure. However, due to the scarring, fluid collections under the skin, nerve damage and wound problems associated with the surgery it was not very popular. According to the American Society of Plastic Surgeons statistics as recently as the year 2000 more than 300 women got upper arm lift procedures in the US. Last year, 2012, the number increased to more than 15,000. 98% of these patients were women, 42% had undergone previous weight loss surgery, 63% were aged 40 to 54 and 33% were over age 55. The total spent on brachioplasties in 2012 was $61 million. What accounts for this 5 fold increase in the number of procedures over 12 years? Some of this is due to the increase in weight loss surgery. Over 200,000 Americans a year undergo some kind of weight-loss surgery, such as gastric bypass.

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