Brachioplasty after massive weight loss: a simple algorithm for surgical plane.

After massive weight loss, patients experience a severe skin laxity of the arms with or without associated fat deposits. More than 20 years elapsed after the first aesthetic brachioplasty in 1954 before this problem was addressed with significant technical innovation. The current brachioplasty techniques are somewhat unpredictable and commonly associated with significant untoward results and complications including misplaced, widened, or hypertrophic scars as well as contour deformities resulting from overcorrection centrally and underresection. The authors define preoperative marking that permits reduction of overcorrection problems and makes the surgical technique easy for young surgeons. They have performed this procedure for 6 years with satisfactory results.