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Michael C. Fasching, M.D.

Board Certified Plastic Surgeon


Brachioplasty or Liposuction: Which Procedure Suits Your Needs?

Submitted by Dr. Fasching on Mon 07/16/2018 - 17:03

With the arrival of summer, the warm weather is allowing for cooler clothing options like tank tops, short-sleeved t-shirts, halters, and sleeveless dresses. These choices may bring some anxiety to both women and men who are not happy with the size or tone of their upper arms.  Aging allows stubborn fat to settle in the upper arms causing a problem with size and firmness. Additionally, pregnancy or weight fluctuation often leave excess skin which may hang freely between the shoulder and the elbow. Although there are exercises that can address muscle tone, sagging skin or excess fat may require additional help.

Fortunately, patients now have access to plastic surgery procedures which help eliminate loose skin and excess fat, resulting in a sleek and toned upper arm. With cosmetic goals which focus on sculpting the upper arms, patients have two surgical options at their disposal.


Plastic surgeons perform liposuction more than any other body contouring procedure in the United States. A popular target area is the upper arms. It is a proven treatment to remove unwanted fat which has not responded to diet and exercise. Liposuction for the upper arm area is popular with patients who want help with arm contours, seeking a tighter and shapelier outline.

There are multiple liposuction techniques, all involving Dr. Fasching inserting a cannula (a narrow tubular device) through a tiny incision and suctioning out unwanted fat.

Fluid Injection Technique

Fluid Injection involves injecting a medicated solution into the target area before removing the unwanted fat. The fluid is a blend of epinephrine (a drug that contracts blood vessels), lidocaine (a local anesthetic) and saline solution which helps remove the fat easily. The mixture provides an anesthetic and reduces blood loss as well as post-surgery bruising.

Tumescent Technique

Wet solutions like tumescent are introduced into the fatty layer of skin before the fat is suctioned. Before wetting solutions, liposuction went in dry with a higher risk of bruising and bleeding.

Tumescent liposuction uses a solution of lidocaine, adrenaline, and saline. The adrenaline contracts blood vessels to reduce bleeding as the fat is extracted.  This technique causes the skin to become firm and swollen (tumescent). Tumescent liposuction uses more fluid than any other liposuction technique, using up to three times more than the targeted fat volume.

During a tumescent liposuction procedure, Dr. Fasching will mark your upper arm to identify the targeted fat. Then, anesthesia will be administered (general anesthesia or a local with IV sedation).

Next, Dr. Fasching administers the solution into the fat deposits under the skin to prepare for extraction. He then inserts the cannula into the fat layer through a tiny incision. The cannula is attached to suction, and with a back and forth movement, the fat breaks down small enough for extraction.

You will wear a compression garment after treatment to support the incision and help it heal.

Super-Wet Technique

Dr. Fasching has another liposuction technique in his arsenal which achieves natural-looking upper-arm results. For patients looking to sculpt their upper arm into a well-defined, sculpted tone, the super-wet technique may be the best option. This technique uses a specific solution to reduce the duration of the procedure and limit any bruising or swelling which often occurs. This advanced option is suitable for patients who seek a long-lasting outcome.  Super wet liposuction is designed for precise and large-volume fat removal.

The super-wet liposuction technique employs a different solution to lessen discomfort during the procedure. This solution is introduced into the upper arm to provide a firming effect. Next, fat removal is easily and safely suctioned away.

The amount of fluid necessary for a super-wet technique is more than the fluid injection and less than the tumescent technique.


An arm lift (Brachioplasty), is a surgical procedure designed to remove excess skin from the upper arm area. With age, the skin loses elasticity and starts to sag. This sagging is a problem with patients who lose a large amount of weight because of weight loss surgery or significant weight fluctuation. However, flabby upper arms can still affect thin people who watch their diet and exercise regularly. A Brachioplasty can be performed as a standalone surgery or concurrently with liposuction.

This surgery employs general or local anesthesia with IV sedation and takes from one to three hours.
Incision placement depends on the volume of tissue to be removed. Those patients with little excess skin and tissue require a small incision in the armpit area. Larger amounts of tissue targeted for removal may require a larger incision which starts at the elbow and runs to the underarm. For still larger amounts of tissue, the incision can run to the side of the chest.

After Dr. Fasching removes any excess fat, he trims and tightens the skin. Lastly, he closes incisions with absorbable sutures or stitches.

Brachioplasty benefits include:

  • Smaller upper arms
  • Shapelier and more toned upper arms
  • Removes excess skin and tissue
  • Eliminates flabby upper arms
  • Younger-looking, sleeker arm contour

After Brachioplasty surgery, Dr. Fasching will dress the incisions and provide a compression garment to reduce swelling. Patients will experience bruising and swelling initially, but both should subside within a couple of weeks. Patients are instructed to keep arms elevated when possible to prevent swelling. Most patients can shower one week after surgery, go back to work after two weeks and resume working out after one month. However, patients should abstain from lifting heavy objects for six weeks.

An arm lift carries certain risks, including loss of sensation, bleeding, and infection. But by following Dr. Fasching’s post-surgery instructions, risks are reduced dramatically.


With a full understanding of each procedure, you should have a pretty good idea of which surgery will work best for you to eliminate upper arm contouring issues. Liposuction is designed to remove excess fat while Brachioplasty can eliminate excessive skin. Although the procedures are often performed concurrently, they are each standalone surgeries designed for different aesthetic problems.

To learn more about removing unwanted fat deposits and excess skin around the upper arm, call Dr. Fasching today at (763) 577-7500 or schedule a consultation.