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 Almost every woman over the age of 50 has something to say about her arms, and it's not usually complimentary. Women feel as though they lose tone in their arms and want to "tighen them up." Comments such as "my arms look like I'm old," or "I can't wear sleeveless tops anymore," are not uncommon. In order to understand the different surgical and nonsurgical options, it is important to understand what is "loose." Usually it's not just skin that loses tone overtime, but fat accumulates, and muscle loses tone too. It's very easy to just grab whatever extra and think it's fat, or skin or just "stuff" you want to get rid of. The first thing to do is to make sure that your muscle is as toned as possible. That requires excercize but it is well worth it. Any excercize that helps your tricep muscles (the ones in the back of your arm) will work Once you feel as though you have toned your muscle as much as you can, the next step is to work on the fat. One way to do this is through weight loss and the other is through liposuction. There are two excellent techniques for this. I use either SmartLipo or VASER liposelection. Both of these techniques are advanced liposuction devices that don't just help to suction the fat, but also are designed to help the skin to tighten up too. However, it is important to have realistic expectations. Liposuction of the arms (no matter what technique) is usually only useful for women in their 20s and sometimes into their 30s or 40s. After that the skin is not toned enough, so that if you only do liposuction (even with the skin tightening of the VASER or Smart Lipo),the extra skin may not contract and you will possibly get skin results that are more unsightly than what you started with. There two main techniques for surgical arm lifts. One is the "short scar" technique that combines liposuction with removal of an elipse of skin under the arm. The advantage of this procedure is that the scar is well hidden, and does tighten the skin some. Coupled with liposuction this procedure can give good results. The second arm lift procedure is a longer vertical incision that is placed on the back of the arm but is also hidden from view. The incision in this location usually produces an excellent scar, but it is a scar nonetheless. It may seem that the "short scar" technique would be much more appealing than the long scar, but it is very important to understand that the short scar only removes a relatively small amount of skin. Many patients want the effects of the longer scar but with the shorter scar. As with many things in life, arms lifts are a tradeoff. But they can provide dramatic improvements in the right situations. Dr. Josh Korman, M.D., is certified by the American Board of Plastic Surgery and has been a member of the clinical faculty of Stanford University for 15 years. He is also a member of the American Society of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, and the California Society of Plastic Surgery. He received national attention for his use of lasers in plastic surgery and for body lift surgery. Dr. Korman has been featured on "20/20"; CNN; The New York Times; The San Jose Mercury News; Gentry Magazine, and The Metro. Dr. Korman volunteers his services as physician in developing countries with Interplast; he has served on its board of directors. Locally he donates his time to the Community Breast Health Project in Palo Alto, Calif. He is an accomplished musician and playwright. He has been named one of San Jose Magazine's "Top Docs" every year since 2000. Visit his website at www.kormanmd.com. Send your questions to Josh@smartnow.com.
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