An oft-overlooked area for rejuvenation treatments is the upper limb, encompassing the arm (from shoulder to elbow) and the forearm (from elbow to wrist), not to mention the top surface of the hand. As such a patient’s upper limbs can be an easy give away to their true age.
By Dr. James Southwell Keely, Cosmetic, Reconstructive and Plastic Surgeon
As with the rest of the body the upper limb is subjected to the ravages of time and the aging effects of sunlight. As we age our skin thins, becoming loose and wrinkly in appearance. Sunspots and blotchy pigmentation go further to confirm one’s age. Finally fat disappears from the hand but builds up in the arms filling out the loose skin creating “bingo wings”.
Treatments aimed at removing the stigmata of aging should be targeted to the individual, as not all may be present. Fraxel laser stimulates the replenishment of the skin. In so doing it irons out wrinkles and removes or greatly reduces sunspots. Fillers and fat grafting can be judiciously used on the top surface of the hand to help conceal veins that become increasingly evident as we age.
Excess fat tends to accumulate in the arm rather than below the elbow. Liposuction can be used to remove this fat and, if the patient’s skin retains its youthful qualities, will re-establish a smooth arm contour all on its own. However if too much skin persists after liposuction or if the patient’s skin has lost its elasticity so cannot re-contour, then an arm-lift will be necessary.
A small arm-lift entails removing an ellipse of skin citing the scar in the armpit, while a larger arm-lift results in a scar running for a variable length down the inner aspect of the arm. The key to a good arm-lift involves minimising the appearance of an otherwise obvious scar.
As with all areas of cosmetic surgery prevention remains better than cure. And while the aging process cannot be stops, its progress can be slowed with a healthy diet, regular exercise, smoking cessation and sun protection.
