This article was written by Dr. Brian Peterson in an issue of Bliss:
Batwings
No, it’s not an evolution of the human race that will allow us to fly someday; it is a collection of loose skin and unwanted fat in the upper arm that primarily affects women. It often keeps them from wearing short sleeve shirts, tank tops and sleeveless dresses, trying to conceal the upper arm with long sleeve garments. No fun, especially in the Okanagan summers.
Once again, the cause is multifactorial. Genetics, a history of obesity and weight loss, and sometimes just bad luck. The onset is usually in the 40’s and the severity increases with age, as skin tone is lost and fat is redistributed to the centre of the body, and muscle mass is lost. Loose skin starts to hang in the upper arm or triceps muscle area. People often over diagnose the problem by bending their arm at the elbow, and feeling the loose tissue on the under surface. This puts the large triceps muscle at rest and it feels like further loose tissue. You really need to contract the triceps muscle by resisted forced extension of the elbow (against a wall) to actually see how much loose skin and fat is present.
Many forms of non-surgical treatment have been recommended, none of which work well. Topical creams with aminophylline (used for treatment of asthma) have been tried unsuccessfully as any benefit stops when the creams are discontinued. Mesotherapy, which is the injection of a detergent irritant into the fat layer, produces an uncontrolled inflammatory reaction with hopefully the liquefaction of fat. Lumpy, irregular results without skin tightening are usually seen, especially when large areas are treated. Thermage, which uses a form of high intensity energy transferred to the skin to tighten it is being tried, but is still in the early phases of development.
So what works? Unfortunately surgery is the only real answer. In the younger age groups, 40 -50 with primarily fat deposits and good skin tone, liposuction is an excellent form of treatment. This does count on the ability of the skin to contract after the fat is removed, and skin waviness is the main potential side effect.
Once reaching age 50, most people require direct excision of the excess hanging skin and fat. The incision and eventual scar is on the inner aspect of the arm and although quite visible for the 1st 6 months, it does fade nicely with time, especially in this age group who are less prone to red angry scars. Part of the removed tissue also includes some of the sweat glands in the armpit area so perspiration is permanently decreased. Although I was initially hesitant to introduce this procedure into my practice because of the scar, I have not encountered a patient who would rather have the loose tissue. Once the scar is mature these patients freely wear any type of clothing they desire.
This procedure does require a general anaesthetic, and is performed on a day care basis. Temporary diminished feeling to the inner arm and infection are the most significant risks, less than 1%. Recovery, back to most activities is about 3 weeks. As always consult a Board Certified Plastic Surgeon.
To find out more about any of these plastic surgery procedures, contact the Peterson MD clinic today on (250) 868-9099 or 1-888-505-8895.
