Evaluation of circumferential liposuction of the arm and fat transfer to bicipital groove in grade I and II contour deformity

Background: The process of arm contouring has presented considerable challenges over years. Numerous classifications have been proposed by skilled and experienced plastic surgeons to achieve superior outcomes while minimizing complications. Most of patients request contouring of their arms without incisions and with a shorter recovery time. Liposuction targeting three distinct zones of the upper arm coupled with fat transfer to the bicipital triangle, implemented without skin excision, constitutes an advanced approach tailored for individuals presenting with Grade 1 and 2 contour deformity. Objectives: The present work aimed to assess the outcome of arm contouring using both circumferential liposuction of the arm and fat transfer to bicipital triangle without skin excision, and to offer an alternative solution for brachioplasty with its unpleasant complications. Methods: Arm contouring was performed in 20 female patients complaining of brachial lipodystrophy; grades IIA and IIB (mean age, 36.5 ± 4.9 years), over 13-month period. Post-bariatric surgery individuals, those classified with severe brachial ptosis as grades III or IV, were excluded from the study. Preoperative and postoperative mid-arm circumference was measured for all cases at 2 months postoperatively. All patients were discharged on the second day after surgery, and underwent regular outpatient follow-up for 6 months. Results: In this study, the patients' BMI was between 28.5 and 35 kg/m2. The mean volume of fat injection in the bicipital triangle was 82.7 ± 18.3 SD ml, per side. The mean reduction in mid-arm circumference was 7.16 ± 0.45 SD cm, with a 18.5% reduction from the preoperative measurement. There was a statistically significant reduction in the arm ptosis (mean, 2.93 ± 0.57 SD cm). There were no recorded major complications. The outcome survey results showed that 14 (70%) patients were very satisfied, 4 (20%) cases were satisfied, while 2 patients (10%) were fairly satisfied, with no reported any dissatisfaction. Conclusion: The procedure of arm contouring, performed through circumferential liposuction of the arm in conjunction with fat transfer to the bicipital triangle, yields satisfactory results for patients with mild to moderate (grades 1 and 2) brachial lipodystrophy, thus eliminating the requirement for excisional surgical procedures.