With the First Lady asserting her right to bare arms, women all over the nation are wondering whether their own arms would be White House-worthy. It is a biological fact that once women hit a certain age, the skin on the underside of their arms starts to sag. And once gravity takes its toll, skin laxity, combined with the visible layer of upper-arm fat that commonly vexes the female sex, often leads to insecurity about certain fashion choices. Tank tops, halters, and sleeveless dresses become relics of a less flabby time, while cardigans, sweaters, and matronly frocks take their place.


But there is hope for bare arms. As reduction-oriented plastic surgery has become more advanced, women are increasingly turning to cosmetic procedures to nip excess arm fat and skin in the bud. We chatted with Dr. Anthony Youn, a Board-Certified plastic surgeon specializing in cosmetic enhancements, to gain a better understanding of what options are available to arms slenderly-challenged arms.


Why are women plagued with more under-arm fat and skin than men?


Genetically, women have a higher body fat percentage than men, and often have thinner skin, predisposing them to having heavier arms.


At what age do women typically start to see a sagging effect?


This varies with genetics, but typically by the mid 50's.


Do some women have a genetic predisposition to flabby, sagging arms?


Yes, if your mom has flabby arms then you may develop them as well.


What causes arm cellulite and how can it be treated?


Arm cellulite is usually due to a combination of fat and loose skin.There are many treatments that can reduce the appearance of cellulite, including Dermosonic and Velasmooth.While they are more commonly used on the thighs and buttocks, these treatments can also be used on other parts of the body.


Are there specific lifestyle changes and exercises that can shrink arm flab?


Not necessarily.The best way to shrink arm flab is to decrease the overall body fat percentage by diet and exercise and to strengthen arm muscles with weight training.


What kind of procedures do you recommend for giving the triceps area more definition?


Arm exercises are the best way to define triceps, but surgically, liposuction can help remove any excess fat. Another option is brachioplasty, otherwise known as the batwing procedure. This surgical treatment is aimed particularly at tightening the loose, hanging flesh of the upper arm which resembles bat wings. After making a well-hidden incision from the top of the underarm to several inches above the elbow, the surgeon removes excess flesh and fat and tightens muscles in the area if necessary.


Please describe what the patient experiences with the Batwing Procedure.


If the patient only needs liposuction, there is usually minimal swelling and a quick recovery over several days. With the actual arm lift surgery, there is a lengthy scar that extends from the armpit to the elbow, and a considerably longer recovery time of around 2 weeks.


In what instances do you recommend liposuction of the upper arms?


This is a good choice for people who have excess fat on the upper arms without significant loose skin. It is a remarkably easy procedure, because often the removal of a small amount of fat-- around 100 cc's-- makes all the difference. The procedure is performed under local anethesia with sedation on an out-patient basis, and the upper arms are wrapped in ace bandages for several days to minimize swelling or bruising.


How does liposuction in this area compare to that of the thigh, buttocks, or abdomen?


Surgeons must be a bit more conservative, since there are very important nerves and blood vessels that run through the arm. The other areas on the body don't require that surgeons be quite as conservative.


What is the general cost range of these procedures?


Liposuction: about $2500


Arm lift (brachioplasty): about $6000


What do you see as the next development in cosmetic surgery?


Lasers are improving every year. Considering the large scars associated with arm lift surgery, many patients are waiting for the day that lasers are effective in visibly tightening up the skin of the upper arms.When lasers are improved to this extent, arm lifts will become less and less popular.