Pinch the skin on the back of your upper arm and let go. If it snaps flat, liposuction works. If it stays creased, removing fat leaves a hanging arm.
Pinch the loose skin on the back of your upper arm, hold it for two seconds and let go. If it snaps back flat, the bulk is fat and liposuction alone will work. If it settles back slowly or stays creased, the skin has lost its elasticity and removing fat underneath will leave a deflated, hanging arm. That is the whole decision, and it is why we ask for photographs with the arm held horizontal rather than by the side.
Younger patients whose arms have always been heavy, who have not lost a large amount of weight, and whose skin still retracts, do well with liposuction alone. Vaser liposuction starts at €2,400, leaves two small entry points near the elbow and armpit, and there is no visible scar to explain. Recovery is a compression sleeve for four weeks and back to desk work within days. It is the better operation when it is the right operation.
After significant weight loss, or past about the mid-forties in skin that has already lost its recoil, the fat is not the problem — the envelope is. An arm lift from €2,600 removes a strip of skin along the inner arm and closes it, trading looseness for a scar you will be able to see. Many patients have both in one operation: liposuction to debulk, then excision of the excess skin over it, which is planned as a single procedure.
We will not do liposuction alone on an arm that fails the snap test, even when the patient asks for it specifically to avoid a scar. The result at three months is a thinner but emptier arm, and the correction is the arm lift you did not want, now performed through tissue that has already been operated on. If your photographs show that answer, we will write it to you before you book flights rather than raise it on the morning of surgery.
A little, and only where elasticity is still present. Vaser transmits energy that produces some contraction of the overlying skin, but the effect is measured in a modest percentage, not in centimetres. It never substitutes for excision in an arm that fails the snap test.
No, it is more expensive and a worse result. Two operations, two recoveries and two trips, with the second performed through scarred tissue. If the snap test says the skin will not retract, the honest plan is the arm lift from the start.