Brachioplasty: Are there any alternatives to arm lift surgery?

Arm lift, or brachioplasty, is a surgical procedure designed to firm the arms and give them a more toned, supple appearance. It is purely an aesthetic intervention, meaning it is not carried out for any medical indication. In other words, brachioplasty is not an essential operation aimed at improving the patient’s health.

Before a brachioplasty, a preoperative consultation with the surgeon is essential to review the medical history, explain the procedure and confirm the indication. Investigations such as blood tests or radiography may be required. The patient must also adopt a healthy lifestyle, notably by ceasing smoking and alcohol consumption. Thorough preparation is crucial to enter the operation with confidence. Brachioplasty, or arm lift of the arms, begins with a general or local anaesthetic. The surgeon then performs incisions on the inner aspect of the arms to remove excess skin and fat. Liposuction may be combined to refine the contour. Finally, the tissues are sutured and the area is covered with a dressing to promote healing.

However, this procedure is not without risk and may present several contraindications and side effects, which raises the question of less invasive alternative solutions. The main contraindications include: coagulation disorders, certain cardiovascular conditions, diabetes or smoking. These conditions increase operative risks and compromise healing. Even in a healthy patient, brachioplasty can result in complications such as haematomas, infections, impaired wound healing (thick or hypertrophic scarring), temporary loss of sensation, or asymmetries. This is accompanied by postoperative sequelae, often characterised by pain, swelling and a recovery period lasting several weeks.

Radiofrequency is a non-invasive technique used to treat skin laxity by stimulating the production of collagen and elastin, two proteins essential for skin firmness and elasticity. It relies on the emission of electromagnetic waves through a device applied directly to the skin, which penetrate deeply to generate controlled heat (between 38°C and 42°C at the surface, and up to 60°C in the dermis) without damaging the epidermis. This heat causes an immediate contraction of collagen fibres, providing a visible tightening effect from the very first session. It also stimulates fibroblasts, which are responsible for the production of new collagen and elastin fibres, thereby progressively improving skin firmness.

The results manifest as smoother, firmer skin, with a skin laxity reduced over successive sessions. The technique, well tolerated, generally does not require any social downtime, apart from slight transient redness. While it is frequently used for the face, neck or abdomen, radiofrequency is also an interesting solution for treating moderate skin laxity of the arms. A protocol comprising several sessions spaced over time is generally recommended to achieve a lasting result.

A study conducted on 33 women patients highlighted the efficacy of radiofrequency for the treatment of skin laxity. Six radiofrequency sessions, carried out between 6 and 12 months, were required to address the abdominal region. Several histological changes were observed, reflecting a structural improvement of the dermis and theincrease in the depth of the collagen refringence band (9.7% at 6 months), indicating the existence of long-term collagen remodelling, as well as an increase in papillary height. This latter term refers to the thickness of the papillary layer of the dermis, located immediately beneath the epidermis. This zone is rich in blood capillaries and fibroblasts, the cells responsible for producing collagen and elastin. This layer decreases with age and exacerbates skin laxity. According to the observations, papillary height increased by 28.9% at 6 months and by 40.3% at 12 months.

Radiofrequency could increase papillary height by reactivating biological activity in the dermis, thus improving skin density, firmness and texture.

Although this study focuses on the abdominal region, it can be assumed that this technique applies to various parts of the body, notably the arms.

The use of ultrasound represents a non-invasive technique known as HIFU (High-Intensity Focused Ultrasound). This approach is designed to tighten lax skin without surgery. The device emits focused ultrasonic waves at various depths beneath the skin, specifically 1.5 mm, 3 mm and 4.5 mm, to target the epidermis, the dermis and the deeper supporting tissues, thereby stimulating collagen production and delivering a non-surgical lifting effect. This produces focal thermal coagulation within the targeted tissues, without damaging the skin’s surface, and induces a immediate contraction of collagen fibres and stimulates fibroblasts to restart the synthesis of new collagen and elastin. The skin then progressively becomes more toned and firmer over a period of two to three months. However, this technique is less radical than a facelift and is reserved for moderate cutaneous laxity.

In a review published in Aesthetic Surgery Journal, 42 studies encompassing a total of 411 patients were analysed to assess the efficacy of focussed ultrasound in improving skin laxity. The results show that 84% of patients reported being satisfied with this technique, across all criteria. Although the majority of research focuses on the areas of the face and neck, it is reasonable to assume that this procedure could also be applied to other regions of the body exhibiting moderate skin laxity, notably the inner upper arms.

Adopting a healthy lifestyle forms a fundamental approach to improving the appearance of the arms. It rests on two complementary pillars: a balanced diet and the regular practice of physical activity. Among the most effective exercises for strengthening muscles and limiting skin laxity are arm curls, triceps extensions, press-ups and dumbbell lifts. Combined with sound lifestyle habits, these movements progressively tone the area and reduce fat accumulation. The key lies in consistency and discipline: frequent lapses or irregular practice can compromise the expected outcomes.

Although this method can enhance the firmness and contour of the arms, it is generally unable to eliminate excess skin once it has become established.

The results therefore remain limited in cases of significant skin laxity and are not comparable to those achieved with more targeted medical or aesthetic techniques.

• ELSAIE M.L. & al. Cutaneous remodelling and photorejuvenation using radiofrequency devices. Indian Journal of Dermatology (2009).

• CHAN H.L. et al. Safety study of transcutaneous focused ultrasound for non-invasive skin tightening in Asians. Lasers in Surgery and Medicine (2011).

• TANZI L.D. et al. Non-invasive lifting of the skin of the arms, thighs and knees using transcutaneous intense focused ultrasound. Dermatological Surgery (2012).

• FABI S. G. et al. Microfocused ultrasound with visualisation for skin tightening and lifting: my experience and a review of the literature. Dermatologic Surgery (2014).

• FOUQUE L. & al. Treating multiple body areas for skin laxity and fat deposits using a novel, focused radio-frequency device with an ultrasound component: a safety and efficacy study. Journal of Cosmetic Dermatology (2017).

• DEMIRCI G.T. et al. Efficacy and safety of high-intensity focused ultrasound in the treatment of upper-arm laxity: Our experience with five patients. Journal of Cosmetic Dermatology (2019).

• Ola S. et al. Arm liposuction with moderate ptosis versus brachioplasty. The Egyptian Journal of Hospital Medicine (2025).