Liposuction (liposuction) is a surgical procedure in aesthetic surgical medicine in which the subcutaneous fatty tissue (subcutaneous fatty tissue) is removed or suctioned by vacuum with the help of an aspiration cannula. Liposuction in the area of the upper arms serves primarily to combat age-related lipohypertrophy (increased fat storage), which is usually subject to a genetic component and usually affects women. In addition, sagging excess skin is often found in the upper arm region, which can be successfully removed by combining liposuction with an upper arm lift. Causes of an unaesthetic upper arm area are, in addition to obesity (adiposity), aging of the skin, severe weight loss, and congenital connective tissue weakness.
Indications (areas of application)
- Unaesthetic fat deposits in the upper arm area that can not be addressed by physical training or dietary changes (body weight reduction).
- Stage 3 lipedema (lipedema extends from the hips to the ankles; health insurance benefit: see below).
Contraindications
Absolute contraindications
- Known allergy to anesthetics or local anesthetics of tumescent anesthesia.
Relative contraindications
- Known tendency to convulsions (epilepsy)
- Taking anticoagulants (anticoagulant medications).
- Too high expectations of the patient for the outcome of the operation
- Severe heart disease
- Severe lung disease
- Severe liver damage
- Severe kidney damage
- Tendency to thrombosis (thrombophilia)
Before surgery
Before surgery, an intensive medical history discussion should be conducted that includes the patient’s medical history and motivation for the procedure. The procedure, any side effects, and the consequences of the surgery should be discussed in detail. Note: The requirements of the explanation are stricter than usual, since courts in the field of aesthetic surgery demand a “relentless” explanation. Furthermore, you should not take acetylsalicylic acid (ASA), sleeping pills or alcohol for about fourteen days before the operation. Both acetylsalicylic acid and other pain relievers delay blood clotting and can cause unwanted bleeding. Smokers should severely limit their nicotine consumption as early as four weeks before the procedure to avoid jeopardizing wound healing.
The surgical procedure
Liposuction in the upper arm area is one of the minor procedures of this type. Localization for the operation are the outer and dorsal sides (back sides) of the upper arms. Somewhat less frequently and usually together with an upper arm lift, liposuction is performed on the inner sides of the upper arm. Before the operation, the patient is questioned in detail as part of the anamnesis and informed about risks and complications. The surgical area is carefully marked on the standing patient with normally hanging arms. During the operation, the patient is placed either in the supine or lateral position. The operation can be performed either under local anesthesia (local anesthesia) or under general anesthesia. For local anesthesia, tumescent local anesthesia (TLA) is used: In the first step, one and a half to several liters of a mixture of sterile, isotonic water, sodium bicarbonate, a local anesthetic (drug for local anesthesia) and often also some cortisone are infused into the subcutis (subcutaneous fatty tissue). After a 30-minute waiting period, the infused fluid is evenly distributed in the fatty tissue. A kind of emulsion of fat cells and tumescent solution is formed, which makes the actual liposuction much easier. The operation takes one to two hours, depending on the individual findings.
After the operation
After the operation, a bandage is applied, which consists of an elastic bandage, among other things, and must be worn continuously for about 3 weeks. This is to ensure stability and the shape of the surgical result. Physical stress and direct sunlight on the surgical scars should be avoided for the next 1 to 2 months. Redness of the scars may persist for several months.
Possible complications
- Allergic reactions – e.g., to the anesthetic.
- Tearing of the wound edges
- Dysformities in the suction area
- Post-bleeding
- Hematomas (bruises)
- Keloids – increased scarring
- Edema (swelling)
- Pain, feeling of tension
- Sensory disturbances
- Thrombosis – vascular disease in which a blood clot (thrombus) forms in a vessel.
- Wound healing disorders due to circulatory problems.
- Wound infections
Benefit
Liposuction in the upper arm area is an effective procedure to remove annoying fat deposits and restore a beautiful upper arm contour. Note on the legal basis for the recognition of liposuction as a therapeutic measure by the statutory health insurance (SHI): since January 2020, the service has been covered by the SHI for stage 3 b lipedema. In addition, proof of successful conservative therapy over 6 months must be provided. The same applies to patients with obesity grade II (BMI: 35-39.9).
