07/18/2013 10:07 am ET Updated Sep 17, 2013

Disappearing Bat Wings

When many people think of "plastic surgery" they think of facial procedures, like rhinoplasty or facelifts, so it came as a surprise when brachioplasty -- arm lifts -- made recent headlines for its exponential growth in popularity.

Brachioplasty surgery reshapes the upper arm and minimizes so-called "bat wings" by removing excess skin, resulting in smoother skin and a more toned appearance. More than 15,000 women underwent brachioplasty last year -- an increase by more than 4,000 percent since 2000, and one which I estimate will continue to grow.

Aesthetic facial procedures can be placed into one of two conceptual categories -- interestingly, patients seeking brachioplasty may fall into either one:

  • Recontouring procedures alter the basic shape of structures. Rhinoplasty, otoplasty, and chin augmentation alter the shape of the nose, ears, and chin, respectively.
  • Rejuvenative procedures are those intended to make you look younger. These operations (e.g. facelift, neck lift, blepharoplasty) involve removing or elevating soft tissues that have fallen or become more redundant with age. Surgery lifts, repositions and removes excess skin.

Patients who have lost large amounts of weight to improve their body contours often are left with a stretched out and deflated skin envelope. Abdominoplasty (tummy tuck) and mastopexy (breast lifts) remove the now-excess skin to improve the contours of the abdomen or breast. Brachioplasty improves the contour of the arm. Similar to patients requesting facial contouring procedures, those seeking brachioplasty after weight loss can be young or middle-aged.

Patients whose skin has lost elasticity with age are the other candidates for brachioplasty. These patients are of normal body weight and have the "bat wings" due to the effects of gravity and skin structural deterioration over time. These patients want their arms rejuvenated. The surgery is similar for both groups with the exception that the weight loss patients often require a bit of liposuction to refine the result.

One of the interesting things about brachioplasty is the approach surgeons take to hide the resulting scar -- the surgery is an invasive procedure requiring an incision from the armpit to the elbow. Candidates for the procedure might wonder, "Won't it look obvious that I've had surgery when wearing a tank top? Will I just have to trade one insecurity for another by worrying about scars?"

Those who have viewed successful post-brachioplasty results, however, know just how discretely a skilled surgeon can conceal his or her incision lines. It's true that all surgical incisions result in scars. Plastic surgeons make their scars less visible and, ideally, not visible in several ways. They place incisions in inconspicuous places, such as behind the ears for neck lifts and in lid creases for blepharoplasties.

The long incision for brachioplasty, from armpit to elbow, is hidden by placing it on the inner aspect of the arm next to the body -- where no one can see it. You can see before-and-after examples of successful brachioplasty procedures in this photo gallery from the American Society for Aesthetic Plastic Surgery

Cleverly-placed incisions can help ensure that the increase in patients undergoing brachioplasty is only noticeable in statistics provided by plastic surgeons, not from any obvious scars. As with any successful plastic surgery, only the patient and surgeon need to know.