After losing a significant amount of weight and embarking on a program of vigorous exercise, you may find that you still have loose, hanging underarm skin that resembles bat wings. Although you can improve your upper-arm appearance with exercise, this redundant underarm skin remains a problem that does not improve with exercise.

Arm lift surgery is an operation that removes excess skin and fat from your upper arms that might develop with age or after weight loss.

The aim of surgery is to remove the excess hanging tissue over in the upper arms and sides of the chest. This will help improve symptoms related to the excess skin such as rashes, blistering and irritation. It can also improve mobility by removing the heavy hanging tissue, which may aid in exercise and further weight loss.

Before seeing our Consultant Plastic Surgeons, you should think about what you are hoping to achieve from a arm lift. Points to consider may include:

• Do you have any medical conditions or drug allergies? Are you being treated for any medical conditions?
• Have you had any previous surgeries?
• What are your current medications and vitamin and herbal supplements?
• What is your history with any non-invasive cosmetic procedures?
• What outcome do you expect from the surgery? What is your chief motivation in undergoing an upper arm lift?

An upper arm reduction or an arm lift is usually performed under general anaesthetic and takes 90-120 minutes. Your surgeon will make a long incision between your elbow and armpit. Depending on your condition and situation the incision could be minimal. Be sure to discuss your incision with your surgeon. Segments of skin and fat will be removed and the remaining skin and tissue will be lifted resulting in a tight, smooth look.

Dressings will be applied and small tubes (drains) may be put in to drain any fluid or blood from the wound. Elastic bandages will be applied to support the area. You will be given medication for pain relief.

Upper arm reduction and lift usually takes approximately two hours depending on the amount of reduction required and whether other procedures like liposuction are performed.

You should expect to feel pain and discomfort during the first week of recovery which can be managed with pain relief medication. Your consultant will recommend appropriate medication.

You may be placed in a compression garment or wrap immediately following surgery. Wear this exactly as directed. Remove it only as directed for cleansing incisions or showering. You must have a responsible adult take you home and remain with you continuously for at least 24 hours after surgery. Although rare, emergencies do occur. You should have someone help you to the bathroom the first few times in case you experience dizziness or light-headedness.

Drink only liquids for the first few hours after surgery. Advance slowly to small, light meals. If you experience nausea or vomiting more than once, call your doctor. Excessive vomiting and retching can result in bleeding beneath the skin.

Gently get out of bed as soon as possible after your surgery. Sit with your legs hanging over the edge of the bed or chair for a few minutes before standing. Begin to walk as much as possible as soon as you can, but do not exert yourself. Avoid strenuous activities that involve arm movement, such as raising your arms over your head or lifting. A balance of rest and reduced activity will speed up your recovery.

You will have a mild to moderate amount of pain and discomfort. This should be easily controlled with oral medications.

The discomfort and pain should begin to decrease within 48 hours after surgery. If you have a significant increase in pain after this period, call your plastic surgeon. Severe pain is rare; if you experience this, call the doctor immediately.

Expect bruising and swelling. These symptoms will peak within the first 36 to 48 hours after surgery and will gradually subside over the next 10 to 14 days. To minimise swelling, sleep with your arms elevated with pillows for two weeks after the surgery.

You will need a few weeks to recover and heal from an arm lift procedure. It will be at least one or two weeks before you can return to work and about 10 days before you can drive.

• During the first week, avoid activities that raise your blood pressure, which could cause bleeding at the operative site
• Do not subject your incisions to excessive force, abrasion or motion during the time of healing
• Walking is the safest exercise, especially during the first week
• Avoid exercises that directly stress the area of your surgery for a full four weeks
• After a month, you can start cardiovascular activities, such as riding a stationary bicycle or brisk walking
• Avoid heavy lifting, contact sports and jogging for up to six weeks
• By six weeks after your arm lift procedure, you should be able to resume your normal level of activity