Efficacy of Liposuction of the Posterior Arm Fat Pad in Axillobrachioplasty after Massive Weigh Loss: A Pilot Study.

Background: The topographic anatomical changes of the upper arms and axilla after massive weight loss (MWL) seem ill-described in the literature. The importance of the axilla in MWL brachioplasty and how the procedure differs from the postmenopausal "batwing" deformity of the upper arms is also unclear. Consideration of the underlying pathology seems imperative for a successful reconstruction. We aim to test a procedure specifically designed to mend the underlying pathology of obesity and MWL, liposuction-assisted axillobrachioplasty (LAAB).

Methods: A prospective pilot study was designed to test the effect of LAAB on the axilla and evaluate the results comparative to patient's preoperative complaints and well-being and allow for adjustments for future trials. We measured the diameter of the arm and axilla at three specific points, A, B and C, and applied the arm module of BODY-Q regarding body perception and psychosocial well-being.

Results: Fifteen women, for a total of 30 arms, were included. Age average was 48 years (29-59) and showed a significant improvement in all measurements A-C, most significantly at point A in the axilla, where the reduction was associated with relief of preoperative ailments and great improvement on BODY-Q ratings. The procedure was uncomplicated, with high patient satisfaction.

Conclusions: LAAB significantly improves the axilla and upper arm contour after MWL and correlates strongly with improvement of preoperative ailments. The study furthermore supports the clinical relevance of a posterior arm fat pad. The presented procedure seems to be uncomplicated and reproducible with a high patient satisfaction warranting a long-term clinical trial.