Called “bingo wings” in London, and “lunch lady arms” in New York, flabby, limp, dangling upper arms are the bane of most women’s existence. Even thin women complain about loose arm skin. Women are usually much weaker in the upper body than men, and their skin is thinner which makes it more prone to sagging and dragging. If your mother and grandmother have arms that look like elephant’s ears, chances are you may inherit that trait as well. No matter how hard you work out your biceps and triceps, drooping arms are a naturally occurring result of skin losing elasticity and gravity.

There are two basic techniques that address this common beauty affliction, armlifts and liposuction. “The most common is the traditional arm lift, introduced in the 1950s in South America, known as a brachioplasty,” says Dr. Alan Matarasso, a plastic surgeon in New York City. This operation removes excess skin and fat through a long scar that runs from the armpit to the elbow, along the inside of the arm. Some of the Brazilian plastic surgeons make this incision in the shape of an S, to conceal it better, but it is still visible. The incisions are needed to lift the skin, tighten the arms, remove the fat, and strengthen the ligaments for internal support.

For some, it’s not exactly an ideal trade off. You are trading unsightly loose skin for big scars that are visible when you raise your arms or even hail a taxi. According to Dr. Matarasso, “Women who have had dramatic weight fluctuations, and now have very saggy skin, usually find this operation worthwhile. Those with a small amount of loose skin do not always want to have the scars and will prefer liposuction.”

If fat is your major problem, then lipoplasty alone will reduce the fatty deposits and give you a smaller circumference, but it doesn’t produce super buffed Madonna-like arms. They will just look better in clothes and tight sweaters, which may be enough improvement to make some women happy. According to Dr. Foad Nahai, President-Elect of the American Society for Aesthetic Plastic Surgery, “Lipoplasty is most suitable for younger women with good skin tone. The main contraindication is minimal fat excess and moderate skin excess. With older patients who have lost a moderate amount of weight, some form of brachioplasty or skin excision is usually required, however, liposuction may be attempted first to see if the results are beneficial.”

The emphasis of upper arm contouring has led to various modifications of brachioplasty operations that have been introduced with mixed results. The transaxillary brachioplasty is the most common of these. After creating a small incision, the surgeon first removes all fat through liposuction. He then pulls the excess skin up toward the shoulder and hides the scar deep inside the armpit.

“The best option is to use very small cannula for careful superficial lipo sculpting, but this is dependent on an acceptable skin elastic component. For flaccid skin, vertical excision works but leaves a long scar, says Dr. G. Patrick Maxwell, a plastic surgeon in Nashville, and author of the soon to be released Breast Intentions (MDPUBLISH, 2007). “The trans axillary brachioplasty is really a compromise procedure with moderate results in most cases.”

Non-surgical approaches to improve upper arm contours are definitely on the rise. The Ultrashape® Contour One device will soon be used in London, Paris and Tokyo to recontour arms using external ultrasound which melts the fat gently in stages without scars or anesthesia. The system is now used for thighs and tummies, but with the smaller handpiece that is under development, it will be suitable for upper arms as well. It is not currently available in the U.S.

Armlifts are also being done by using fine filaments or threads to hike up saggy skin through tiny incisions. “We expect to incorporate the use of Contour Threads® into armlifts and breast lifts in women with a small degree of laxity. This will potentially eliminate the need for visible scars that can be a barrier for women who are considering having something done,” says Dr. Maxwell.

The next frontier in the war against batwing arms is the army of non-surgical skin tightening devices flooding the market. Thermage® was the first of these, followed by Titan® and a slew of others. These systems tighten the skin through radio frequency or infrared laser therapy, or a combination of several different wavelengths of energy that work on the deeper layers of the skin. The advantages are no scars, no surgery, and no recovery, but results are gradual and not dramatic. The treatment also improves the texture of the skin so the crepiness is less noticeable. Skin tightening devices are also being used after liposuction to firm up the skin after the fat cells are pulverized.

It’s no wonder why shrugs, capelets, ponchos and sweeping shawls are the rage this season on the catwalks. They are not just a fashion statement; they are a great way to hide your batwings.

Wendy Lewis is an international cosmetic surgery consultant and the author of 9 books, including America’s Cosmetic Doctors (Castle Connolly). Her tenth book, The Complete Cosmetic Beauty Guide will be published by Orion in September 2007. www.wlbeauty.com

wendy@healthnewsdigest.com

© 2006 HealthNewsDigest.com