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Posts Tagged ‘armlifts’

Preferences in Armlift Scar Location and Shapes

Thursday, September 26th, 2013

 

Armlifts, also known as a brachioplasty, is the most effective procedure to reduce the circumferential measurement of the upper for a profound tightening effect. Because it involves a scar, however, its use is usually restricted to the patient who has drooping ‘batwings’ which usually occurs after significant weight loss in women. But even in those patients who are usually more than willing to accept just about any scar over a very floppy upper arm,it is not clear where the best and most acceptable scar location is.

The excisional location and the resultant scar can have two variables, the location on the arm (inner or back) and the pattern of the scar. (straight or wavy) Plastic surgeons are mixed about where the scar should be placed and numerous surgeons any and all of these possible armlift scar locations and types. There are devout advocates for the different armlift scars, each position stating that it offers a superior scar result.

In the October 2013 issue of the Annals of Plastic Surgery, a paper was published entitled ‘Optimal Placement of a Brachioplasty Scar – Survey Results’. This study addresses the issue of where  and how to place the armlift scars based on a population survery. Using a model’s arm in different position, an armlift scar was photoshopped onto the inside and back of the arm as well as in a straight line and a sinusoidal pattern creating four possible armlift scar appearances. Online surveys were then conducted to assess the scar variables and rate them in their visual acceptability between the general public, plastic surgeons and actual patients who had undergone an armlift procedure.

Using approximately 135 survey responses, the straight line inner arm scar proved to be the most favorable while the inner arm scar that was sinusoidal was rated as the worst. Between these two extremes were the back of the arm scar in which a straight line was rated better than a wavy or sinusoidal one. Even with all other variables were considered (age group, gender) the inner arm straight line scar was preferred. In addition, the survey showed that a longer scar was viewed more favorably than leaving any residual hanging skin.

This armlift scar study is particularly interesting as it goes against what I evolved to over the years. Early in my Indianapolis plastic surgery practice, I always placed the armlift scar on the inner aspect of the arm. Because of protracted wound healing issues from the thinner skin present there and the appearance of the scar, I switched to a more back of the arm scar location where the incision heals better and with less problems due to the thicker skin. I presumed, although not proven by any scientific study, that the back of the arm resulted in better looking scars and that patient considered that scar location to be the best aesthetic choice for them.

This study conflicts my long held opinion on the armlift scar. In preoperative counseling on armlifts, I always ask the patient if they prefer the scar on the inside or the back of the arm..and they almost always universally choose the back of the arm. While this study suggests otherwise, the patient is the best judge of where they want the scar. What the study did not factor in is an intermediate choice of halfway between the inner and the very back of the arm which is my current armlift scar location preference.

Dr. Barry Eppley

Indianapolis, Indiana

An Overview of the 2012 Annual Plastic Surgery Statistics

Thursday, May 2nd, 2013

 

The annual 2012 statistics report from the American Society of Plastic Surgeons is in and its review is always noteworthy. As it provides an overview of what board-certified plastic surgeons have done, it does not incorporate cosmetic procedures than any other physicians may do…so it is not the total real number of all the cosmetic procedures that occur in the U.S.. But it does come from the greatest concentration of physicians who perform the broadest range and the greatest number of cosmetic procedures so it’s numbers do have a lot of value.

Over 14 million cosmetic procedures were performed in 2012, a number that is about 5% greater than the year before. Breaking that number down between surgery and non-surgery, actual cosmetic surgery was down 2% while the collection of procedures that are minimally invasive were up by 6%. This is a trend that has been going on for years now as more and more people of all ages participate in the benefits of Botox, injectable fillers and various laser and medical skin treatments. The neuromuscular modulators, such as Botox, rose to greater than 6 million performed for the first time ever.

The top five non-surgical procedures, which overall increased 6%, included Botox +8%, injectable fillers +5%, chemical peels +2%, laser hair removal +4% and microdermabrasion +8%.

The top five surgical procedures, which was down by 2%, included breast augmentation -7%, rhinoplasty 0% change, eyelid lifts +4%, liposuction -1% and facelifts +6%.

As can be seen by the numbers, facial rejuvenation procedures rose the most in both surgical and non-surgical areas as a reflection of an aging population that sees the value of maintaining a less tired and more youthful appearance. It is also a reflection of the burgeoning number of options available for facial rejuvenation from injections to numerous energy-based devices. By the numbers the following facial procedures showed increases: intense pulsed light +10%, laser resurfacing +9%, Botox +8%, microdermabrasion +8%, injectable fillers +5%, facelift surgery +6% and eyelid lifts +4%.

In the body contouring area long dominated by female breast and abdominal procedures, the number of men (even though they are still way lower in total numbers to women) showed a strong increase. Male body contouring was up lead by an increase in the numbers of gynecomastia procedures performed which was up by 5%. The greatest surge in all the body contouring procedures, however, were arm lifts or brachioplasties. While last year’s surprise winner for a great increase in number of procedures performed was chin augmentation, this year it is armlifts. More bariatric patients, improved liposuction technologies and a female cultural focus on better looking arms is behind the greater numbers of arm reshaping procedures.

Dr. Barry Eppley

Indianapolis, Indiana

Combined Armlift and Hysterectomy Surgery at IU Health West Hospital

Monday, February 11th, 2008

Combination Gynecologic and Plastic Surgery Procedure at IU Health West Hospital in Avon, Indiana

 

As the field of medicine and surgery continues to advance, I am continually amazed at how different surgical procedures are being done, not only during the same surgery, but at exactly the same time. This is of great benefit to the patient and maximizes valuable operating room time and resources.

An example of such a case was on February 12, 2008 at the IU Health West Hospital in Avon, Indiana. A female patient was initially seen by me in Plastic Surgery for contouring of her arms to get rid of the flabby skin that inevitably results after a lot of weight loss.. She required formal arm lifts (brachioplasties) combined with liposuction of the area for improvement. She had a gynecologic issue with heavy bleeding and also needed a hysterectomy. The Gyn surgeon and myself worked out a time when we could do the surgery together. Because the operative fields were at ‘opposite ends’ so to speak, we were also able to work at the same time effectively cutting down the total operative time in half.

I have seen over the years a lot of different combinations of surgeries combined with plastic surgery, but a concurrent hysterectomy-arm lift is a new combination for me. When surgeons work together, patients benefit!

Dr Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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