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Thursday, June 09, 2005

Bat-Wings After WLS: Saggy Flappy Arms

Continuing our discussion of plastic surgeries following massive weight loss, today we discuss the dreaded “bat-wings”. You know what I’m talking about - that upper arm skin which hangs like bat wings if you spread your arms wide ready for flight. Wave your hand and the bat-wing waves too. For some after massive weight loss there is so much skin it’s difficult to find shirts with sleeves that fit, and worse, it’s embarrassing to wear sleeveless shirts.

What to do?
The first line of defense is to do weight or strength training during the phase of rapid weight loss. Many patients report satisfactory skin shrinkage of the upper arms when they’ve incorporated light exercise during weight loss. Arm training takes minimal equipment (2 light dumbbells 3-5 lbs each) and limited space. It should be noted, the younger the patient and the fewer times they’ve seen significant weight change, the better chance they have of toning and shaping their arms with exercise. Now, that doesn’t let older patients off the hook for doing exercise - it just gives a bit more encouragement for younger people who undergo WLS. (See the bottom of this post for two effective upper arm exercises.)

The next, but not very plausible option is liposuction. Lipo is only appropriate when there is a lot of fat and the skin is tight. The lipo sucks out the fat and allows the skin to shrink. This isn’t plausible for most WLS patients because they’ve already lost the fat leaving an empty balloon of upper arm skin.

The last resort is the $5,000 arm lift called brachioplasty Brachioplasty is a surgical procedure that eliminates excess skin from the upper arm.

Incisions and Scars in Arm Lift
Scars are the greatest drawback of this operation. They will extend from the armpit to the elbow, along the inside of the arm. This operation exchanges one cosmetic problem (loose skin) for another (scars). In general, those with very loose saggy skin are most likely to find this exchange worthwhile. Those with a small amount of looseness will probably not want the scars.

The Upper Arm Exercises

To shape and tone use a 3-5 pound free weights and do three sets of 12-15 repetitions.

1. Bicep Curls
Stand with feet parallel, hip-width apart, knees soft. Hold a free weight in each hand palms facing forward. To work the lower range of motion, keep elbows tight to your sides and exhale to lift the free weighs as high as your elbows, your forearms parallel with the floor. Lower weights back to your sides and repeat 12-15 times per set.

Next work the upper range of motion, exhale to raise the weights from the elbow (forearms parallel with the floor) to the shoulder. Again, repeat 12-15 times per set.

2. Triceps Kickback with Support

Place left hand on a chair back for support and take a staggered lunge position, left front knee bent over the ankle. Hold a weight (3-5 lbs) in right hand. Keeping spine straight, bend forward from the hip. Bend the right elbow to 90 degrees and raise the upper arm so that it is as parallel to the floor as you can get it. This is the starting position.

Keeping you abdominal muscles tight, exhale while extending forearm behind you so that your arm is straight. You’ll feel this in the back of the upper arm. Pause and squeeze the back of the upper arm. Inhale to return slowly to the start position, keeping the upper arm stationary. Repeat 12-15 times per set. Then reverse sides and work the left arm for the same number of repetitions.

To review some of our early discussions on plastic surgery after massive weight loss click the links below:

Tummy Tuck
Neck Lift

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