Bat Wing Liposuction and Resection
Procedure: Bat Wing Liposuction and Resection
Surgery Length: 3 Hours
Anesthesia: General and/or local with heavy sedation.
Where: Outpatient hospital/Outpatient Office
Recovery: Bruising and swelling of limbs which quickly resolve within two weeks, required to wear a stocking support for two weeks after surgery, Elevation of arms for two weeks after surgery
Back to work: 2 weeks
Full activities: 2 weeks
Risks: Temporary numbness in upper arms with occasional injury to nerves causing permanent numbness and irritability, Minimal chance of grooving is rare, if liposuction is needed minimal chance of hematoma and infection. Scars are visible on inner upper arm and rarely extend to the armpit.
With the loss of weight, or with aging, there is a propensity in some patients to a redundant panniculus or hanging pouch of skin and fat underneath the upper arms. This is particularly exaggerated in those patients that have had excessive weight loss following gastrointestinal bypass procedures. Often times within the course of two years following weight loss there can be a return of elasticity to the arm skin and amelioration of this deformity, but in most cases there still remains a residual bat wing defect.
Treatment of the bat wing deformity includes liposuction as well as excision when necessary. Liposuction can reduce the fat in the upper arms and if there is some residual elasticity in the skin some contraction can occur to improve the overall appearance. Liposuction alone is best done in patients who are younger and have better elasticity and skin tone. Liposuction should be tempered in that excessive liposuction can cause swelling in the hands by interruption of the lymphatics. These “vein-like” structures drain fluids that circulate in our limbs. Injury can also occur to the nerves of the upper arm and elbow area causing numbness and irritability to the sites. Obviously, as with any liposuction, residual deformities such as grooving and residual fat deposits called cellulite or cobble stoning of the skin can remain. Note too, that there is the potential of hematoma (collection of blood) and infection.
Another modality of treatment of this upper arm deformity is the use of excision of the redundant skin and fat. The excision is designed mainly to leave a scar in the inner aspect of the arm. In order to minimize the thickening of these scars, some surgeons have used a technique of breaking up the scar with either a Z plasty maneuver or a lazy S design to the excision so as to leave a non linear scar. The excision is also designed to be limited so as not to undermine extensively and to limit itself between the axilla and elbow. Over step of these margins can cause a contraction at the arm pit or elbow that may be note worthy in some cases. The residual deformities and complications from the upper excisional approach are similar to those noted with the suctioning techniques. However the scarring, on the skin is more extensive and requires more aggressive treatment post operatively inclusive of possible topical cortisone tape (cordran) as well as the potential use of cortisone injections directly into the scars. These patients also require temporary use of arm stocking support for control of swelling. In addition to arm support garments being worn post liposuction and after excision of the arms, the patient must maintain elevation of the limbs during the initial phase of healing so as to hopefully prevent any added swelling that might affect the nerves of the upper arm, forearm and proximal shoulder area.
Both the bat wing liposuction and the excision technique are done as an outpatient. Patients can have one arm done at a time in staged fashion, particularly if there is limited assistance at home place. Both arms are, however, usually done and require the assistance of someone at home.
As with most surgeries, patients are advised to not smoke in or around the time of surgery as the compromise of blood supply is noted when exposed to nicotine inclusive of nicotine patches. These patients are usually given prophylactic antibiotics, and may also be given a steroid pack in and around the time of the operation so as to hopefully obviate some of the swelling from the trauma of surgery. The side effects of these medications are obviously understood and noted at the time of surgery.
If you have any further questions regarding the implementation of these techniques, please do not hesitate to ask our staff.
