A Comparative Analysis of Functional and Aesthetic Outcomes in Brachioplasty Techniques: Posterior, Medial, and Postero-Medial Approaches.

BACKGROUND

Brachioplasty is a critical procedure for upper-arm contouring, particularly in patients with significant skin redundancy following massive weight loss. Different incision techniques-posterior, medial, and postero-medial-offer unique advantages and limitations in balancing aesthetic outcomes, functional improvement, and complication rates.

OBJECTIVE

This study aims to compare the functional and aesthetic outcomes of posterior, medial, and postero-medial brachioplasty techniques to determine the most effective approach based on patient satisfaction, scar visibility, and postoperative healing.

METHODS

A retrospective cohort study was conducted on 90 patients who underwent brachioplasty between 2018 and 2023. Patients were divided into three groups based on incision type: posterior (n=30), medial (n=30), and postero-medial (n=30). Outcomes were assessed using the BODY-Q scar satisfaction module, range of motion (ROM) measurements, and surgeon-assessed scar visibility. Complications, including wound dehiscence and hypertrophic scarring, were also evaluated.

RESULTS

The postero-medial approach showed superior outcomes, with 92% of patients rating results as "excellent" or "very good" compared to 72% for the medial group and 58% for the posterior group (p < 0.001). Scar visibility was minimal in the postero-medial group, with lower rates of wound dehiscence (3%) and hypertrophic scarring (5%). Functional improvements were also highest in the postero-medial group, with a mean ROM increase of 18° ± 2° compared to 12° ± 3° in the posterior group (p < 0.01).

CONCLUSIONS

The postero-medial approach offers the best balance between aesthetic and functional outcomes while minimizing complications. It is recommended as the preferred technique for upper-arm contouring in patients with moderate to severe skin redundancy.

BULLET POINT: Aesthetic scar placement, optimal access to adipose tissue and excess skin, preservation of neurovascular structures.

LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .