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Key Points
- Third-generation ultrasound is minimally invasive compared to traditional procedures
- Ultrasound-assisted lipoplasty is performed under local anesthesia
Ultrasound-assisted lipoplasty of the arm without incision brachioplasty is often the procedure of choice for many plastic surgeons when performing brachioplasty, as the technique is minimally invasive and can achieve very similar aesthetic outcomes compared to other techniques.
Several surgical techniques can be used when performing a brachioplasty, all of them having the common goal of retraction of the skin and aesthetic sculpting of the dorsal side of the upper arm. Surgical techniques can range from smaller excisions to larger ones that can run from the axilla to the elbow region and are considered traditional techniques. These traditional techniques, however, may not be ideal due to their invasive nature and the unwanted scars that they leave behind.
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Dr. Ali
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"Third-generation ultrasound (VASER, Vibration Amplification of Sound Energy at Resonance, Sound Surgical Technologies) is a proven technique in liposuction and has become a novel approach in arm surgery, says Hasan Ali, M.D., a consultant plastic and aesthetic surgeon with a practice based in Riyadh, Saudi Arabia, Dubai and Karachi, Pakistan. "It is minimally invasive compared to the traditional procedures and can achieve comparable aesthetic outcomes without the typical scarring seen in traditional brachioplasty procedures," he says.
PREVIOUS TECHNOLOGIES The first- and second-generation ultrasound devices used for liposuction were fraught with problems and often led to adverse events such as local burns. According to Dr. Ali, the third generation of ultrasound known as the VASER has come of age and emits a controlled heat, achieving remarkable aesthetic outcomes without the safety issues of its predecessors. ![]()
A patient before (left) and two weeks after ultrasound-assisted lipoplasty of the arm without incision brachioplasty. (Photos credit: Hasan Ali, M.D.)
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"I prefer to use ultrasound-assisted lipoplasty such as the VASER for most of my arm procedures. The novel device effectively emulsifies the fat, which can then be aspirated from the targeted areas, without any need for long incisions or excisional surgery," Dr. Ali says.
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A patient before (left) and one week after ultrasound-assisted lipoplasty of the arm without incision brachioplasty.
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According to Dr. Ali, the VASER also can effectively liposculpt the target area and aesthetically shape the arm. Sculpting the arm can be more challenging in conventional brachioplasties, as the surgeon may need to make long incisions along the arm in order to achieve a satisfactory aesthetic outcome. Using ultrasound-assisted lipoplasty, small incisions of approximately 2 mm are required to introduce the ultrasound probe under the skin to perform the procedure.
TRADITIONAL TECHNIQUES Traditional brachioplasty procedures should be reserved for patients who have an exorbitant amount of excess skin that needs to be removed around the arm, Dr. Ali says. Here, a traditional incision brachioplasty technique might be the better choice. "If there is too much skin be removed and too much tissue to be sculpted, it would be more advantageous to opt for a traditional incision technique," he says.
