Friday Figure Fix: Up in arms, part two

Last week, I left you hanging with thoughts of flappy, flabby arms and promises of resolution in the future.

The real challenge for plastic surgeons is dealing with those arms that aren't blessed with the fortune of having fantastic skin resiliency and "flab" due mostly to a small amount of fat. In my Palo Alto plastic surgery practice, that translates to a good 95% of patients out there with this complaint, unfortunately for everyone.

Like I've said in this blog before, plastic surgery is not magic. We don't yet have anything in our plastic surgical armamentarium that makes extra skin disappear without scars. What we do have is surgery, which always leaves scars.

A lot of what makes scars heal nicely (dare I say, invisibly?) is mostly dependent on you and your genetics. A few external, controllable factors come into play: smoking and sun exposure (avoid both if you want to heal well and nicely). Lastly, as plastic surgeons, we do have a few tricks and techniques up our sleeves to make those scars look as good as possible, but again, we're not magicians.

So imagine your arm looks like this:

What you've got there is mostly extra, sagging skin on the underside of your arm; a little bit of fat, too. A brachioplasty removes that extra skin and fat - in a similar fashion to many of the other body contouring procedures we plastic surgeons do (like tummy tucks and thigh lifts) - so that the normal contour of the arm is restored (there's that triceps!):

But like I've mentioned previously, it's not magic. In exchange for getting rid of that stubborn flab, you end up with a long scar along the underside of your upper arm, sort of like a seam on a shirt:

A well placed scar won't be very visible if your arms are at your side. However, not everyone is willing to make that trade off, especially if your goal is to show off in a tiny tank top or bitsy bikini.

The surgery is usually performed under general anesthesia (that means going to sleep with a breathing tube down your throat), takes anywhere from one and a half to three hours, and if the brachioplasty is the only procedure being done, patients can go home afterward with compression garments that need to be worn for several weeks. Routine postoperative follow up and care is done in the office.

Unsightly scarring is always a risk, as well as asymmetry, change in sensation or nerve damage.

Brachioplasty is certainly not a perfect solution for the problem of flabby arms (when our nation's hardworking scientists discover magic, I'll be the first to let you know). But if it's the constant flapping that is the bane of your existence or the nightmare of finding clothes that actually fit, brachioplasty can help change your life.

Next week: maybe we'll tackle the topic of tummy tucks.

Friday Figure Fix: Up in arms

Photo from iStockphoto

Welcome to the inaugural edition of the Friday Figure Fix! Today's topic: batwings, flag wavers, hi-helen's, or simply, flabby arms.

Now that it's the new year, everyone's an optimist about warmer weather coming soon. And warmer weather means we can dust off the tank tops, spaghetti straps, and sundresses that have been languishing in our closets all winter (all of us in the Bay Area could use a little airing out, after hiding out from this deluge all week). And cute tops = bare arms = uh-oh?

It's a near-universal problem for us ladies (more so than men) - we get to a certain age, and suddenly all the definition we may have had in our triceps has disappeared, leaving us with a little looser arm than we'd like. Sometimes there is a perfectly good explanation for the new-onset flabbiness hanging from our humeri - a lack of devotion at the gym, massive weight loss... but often it's a problem that seems to have materialized overnight.

Flabby arms - what's there to do? The first thing to try is the simplest, although not always the easiest: make sure your weight is where it ought to be, and get back to the gym for some arm-toning workouts. For inspiration, look at what amazing things Madonna has done with her arms - no batwing problems there.

Oftentimes, though, all the triceps curls in the world won't do the trick. And that's when you talk to your friendly female plastic surgeon. Hello!

Arms are a tricky thing for plastic surgeons and their patients, especially if the goal is to wear those cute tank tops. If you're lucky, the flab waving is a moderate bit of fat buried beneath good, resilient skin. An illustrative cross section of what I'm talking about, from the inside (muscle) - out (epidermis):


If this is the case, liposuction can be a great solution. A small (1/2 inch) incision, which usually heals to become fairly unnoticeable, allows some of that thick subcutaneous fat layer to be removed, leaving a more proportioned arm.

Liposuction is not magic, however; it is still surgery, and it requires the proper patient, good health, strict postoperative compliance, and patience. Although the procedure itself may be relatively short (often an hour to ninety minutes) and can be done as an outpatient, the care after the surgery is critical. Compressive garments need to be worn on the arms around the clock to ensure optimum results.

Bottom line: after liposuction alone, it'll be at least 4-6 more weeks before you can shed those rather unfashionable garments and replace them with those cute tank tops.

So that's Option One - liposuction for the lucky patient whose flabby arms are the "right" type (again, it's not the solution for everyone). Next Friday, I'll discuss some of the other plastic surgery options for addressing that extra skin hanging off the upper arm; we're talking serious, we're talking brachioplasty.

The cookie that could end my career?

You have to love the indomitable human spirit. Such innovative genius, such creativity, such. . . suckerdom?

One of the more curiously interesting parts of my job involves keeping up to date on all the latest trends - truth, hype, or flat-out falsehoods. The quest for shapelier breasts never ends, and since the tired-and-true method of breast augmentation is, well, surgery, there is always a flashy new product promising the impossible.

I'll have to check out my local Marukai Market to see if they're stocking these Japanese treats, cunningly named "F-Cup Cookie" - available in two flavors (soy milk, and pralines and chocolate, for those of you who are wondering). According to a post in the LA Weekly Food Blog, the cookies contain an herbal root called Pueraria mirifica whose plant estrogens are supposed to do all sorts of things for you, including a boost to your breast size.

Normally I'd say that although eating a cookie like this won't increase your bust, it probably won't hurt. But as Emma Courtland, the LA Weekly blogger eloquently states at the end of her piece: This post is not an endorsement of plastic surgery. Also, F Cup Cookie may cause "loose bowels if taken in excess."

I think my plastic surgical career may be safe after all.

The Friday Figure Fix

Photo from iStockphoto

A new idea here at the My Plastics Life blog - a little bit inspired by the onslaught of Jan/Feb 2010 editions of "girly" mags like Glamour and Elle, the ones that proclaim "New Year! New You!" and "Five Minutes a Day to a Better Body!!!" - you know you've seen those articles, all timed to pounce on universal post-holiday regrets.

Some of the inspiration comes from a drawing class I'm taking in figure representation (yes, all plastic surgeons are secretly tortured artists), and of course, all of those folks I've met who bashfully or boldly ask what a female plastic surgeon like myself can do for their post-holiday bods.

So I'll try to devote some of 2010's upcoming Fridays to posts about some of the most common "fixes" that plastic surgeons offer for those looking to improve their figures.

And it's not just about that little five-pound holiday indiscretion. We're talking about people who have lost significant amounts of weight with medical or surgical assistance or just plain old sweat and tears, and are now stuck with stubborn flaps and rolls of skin disguising their new healthy selves. We're also talking about moms who have seen their bodies undergo the most amazing changes to accommodate a beautiful new being, but once that little human is introduced to the world, their bodies don't exactly snap back to the previous model.

So stay tuned - the Friday Figure Fix will be a fresh and exciting way to learn a little more about this part of the world of plastic surgery!

DUET: Plastic Surgeons to the Stars!

Well, not really. Celebrities like Britney Spears and Lindsay Lohan had been contacting us through our website incessantly (come on, girls - enough is enough!). It was mildly entertaining at first as we seemed to cycle through the A list and down through the B list, I must admit.

Thankfully, a few master keystrokes from our web guru took care of that little spam problem.

But 2010 is still young; we'll see what the rest of the year brings.