Body
How Can I Improve the Shape of My Arms?
Improving arm shape starts with identifying whether the main concern is muscle definition, excess fat, loose skin or a combination. In this episode, Darren M. Smith, MD, a plastic surgeon in New York City, uses those three tissue layers to explain why different arms need different treatment plans.
In this episode.
Episode summary
Improving arm shape starts with identifying whether the main concern is muscle definition, excess fat, loose skin or a combination. In this episode, Darren M. Smith, MD, a plastic surgeon in New York City, uses those three tissue layers to explain why different arms need different treatment plans.
Someone seeking more visible muscle definition may have a different concern from someone bothered by hanging skin after weight loss. The recording walks through exercise, fat removal, energy-based skin treatment and surgical skin removal without treating them as interchangeable procedures.
Key takeaways
🔬 Muscle provides the foundation.
Dr. Smith discusses exercise and, in the context of his 2020 practice, Emsculpt as approaches to muscle conditioning. Neither discussion makes loose skin the same problem as muscle tone.
🔬 Fat can obscure definition.
Arm liposuction removes localized fat. Dr. Smith describes local anesthesia as an option for selected cases.
🔬 Skin quality changes the plan.
If excess skin is the main issue, removing fat alone does not address that tissue. The episode discusses BodyTite for selected patients with less extensive laxity.
🔬 An arm lift removes excess skin.
A full brachioplasty involves a longer incision along the inner arm, with a permanent scar to weigh against the contour change.
🔎 A smaller operation fits a smaller problem.
The mini arm lift discussed in the recording targets more limited excess skin near the armpit. It is not presented as suitable for every arm.
Questions this episode answers
How are arm liposuction and an arm lift different?
Liposuction addresses fat beneath the skin. An arm lift, or brachioplasty, removes excess skin. Dr. Smith explains that some patients have both concerns, so the consultation should identify which tissues are contributing to the shape.
Can a mini arm lift replace a full arm lift?
Only when the distribution of excess skin fits the smaller procedure. The episode describes a mini lift for limited upper-arm skin near the armpit, while more extensive laxity may require a longer incision.
The device protocols, compression instructions and rapid recovery examples in this 2020 recording describe the original discussion. A current plan should specify the procedure's risks, scar placement, expected limitations and individualized activity restrictions.
🔗 Related information
Explore arm liposuction, arm lift surgery, BodyTite treatment information, or request a consultation with Dr. Smith in New York City.
Originally released July 7, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.
Original show notes
A problem-based approach to getting the arms of your dreams, presented by NYC board certified plastic surgeon Dr. Darren Smith.
Read the conversation.
[00:08] I'm board certified New York City plastic surgeon, Dr. Darren Smith, and this is plastic surgery before and after. Your source for the real deal about plastic surgery procedures, news about trends in aesthetic medicine, and candid sessions with industry insiders. We hope you enjoy today's episode. How can I improve the shape of my arms? There are several different ways that we can improve arm shape. And it really comes down to what your goals are and what your anatomical issues are. We can break these possible improvements down as follows. We can improve the definition of the arm. We can make the arm a bit smaller if it's, you know, the circumference is a bit larger than you'd like it to be. We can slim that down. And then there are folks that have excess hanging tissue on their arms. And that's something that we can address very effectively as well. As I've mentioned a few times before in this podcast, I really like to take a problem-based approach to plastic surgery. And here we'll do that by looking at the different tissues of the arm and the problems that they could be causing. So for the arm, there are three basic kinds of tissue that we need to focus on. There's muscle, there's fat, and there's skin.
[01:30] and it's the amount and properties of each of these tissues that in combination define the shape of the arm. So let's go through each of our possible goals one by one and see how changes to muscle fat and skin could help us achieve those goals. So for the person that's looking for better arm definition, the name of the game is to make sure that there is good muscle mass so that we can see those curves and contours in the arms so that we have a good underlying foundation for that. The classic way to improve arm muscle definition is to go to the gym and hit your biceps and triceps. For folks that have kind of maxed out at the gym or just don't have the time or energy to get to the gym as much as they'd like to, a great option is Emsculpt. And Emsculpt uses HIFEM or highly focused electromagnetic energy to cause supramaximal contractions of the biceps or triceps. And in fact, we can use it almost anywhere on the body with some exceptions. And what this does is stimulate muscle contractions that are much stronger than you could ever achieve on your own in the gym.
[02:54] to the tune of about 20,000 reps in approximately 30 minutes. So we find that with four sessions of Emsculpt over the course of two weeks, you can really get some very nice muscle definition. If we want to build a nice muscular foundation for the arm, Emsculpt is a great way to go. So now that we've built up our muscular foundation for the arm, we need to make sure that we can see it. And the things that might prevent us from being able to see that nice muscular definition, are excess fat or loose or extra skin. And this takes us into the next couple categories for the kinds of tissue that we might need to address to get the arms into the shape that we'd like them to be in. So if we have extra fat in the arm, that's going to make the arm's circumference a bit larger than we might like it to be.
[03:48] And it's also going to hide any muscular definition that we've worked to build up. So the best way to get rid of extra fat in the arms is with some targeted liposuction. And liposuction of the arms is a really powerful procedure that is very easy for the patient to go through. And we often do this under local anesthesia so that you don't even need to go to sleep. Of course you can if you want to, but you really don't have to for this kind of procedure. And the way that it works is we make a couple extremely well-hidden incisions that are about two to three millimeters in length, usually in the folds behind the arm where the arm meets the shoulder. So this is something that nobody's really going to see. And we put in some numbing medicine called tumescent fluid. We let that sit for about 10 to 15 minutes to let it take effect. And then we come back with a long thin instrument called a cannula.
[04:45] and carefully suction out the extra fat that we don't want there anymore. The whole procedure usually doesn't take more than 45 minutes. You go home right afterwards. We like you to wear a compressing garment for 48 hours. And that's kind of the story. If you have this done on a Friday, you can be back at work on Monday in almost all cases. And you can even be back at the gym by Wednesday in this example of having the surgery on Friday for most people. So again, a very kind of easy procedure to go through with very powerful results. So now we've discussed how to improve muscle definition to get that great foundation for a really attractive arm shape. And we've talked about how to uncover that muscle so we can see it a little bit better by doing some arm liposuction. But the other thing that stands in the way of, you know, seeing great arm definition and a really pleasing arm contour is extra skin.
[05:44] And there are a couple different ways to approach extra skin on the arms. So for people that have mild to moderate skin excess of the arms, the way that I really like to deal with this is with radio frequency skin tightening, specifically with the body type device. And the way that this works is we use the same very small incisions that we use for liposuction and we put One prong of this device under the skin, one goes over the skin. And radiofrequency energy is passed between the two prongs across the skin. So that's why it's called bipolar radiofrequency energy. One pole is under the skin, one pole is over the skin. And the tissue is heated in a very controlled manner to get to temperatures that we know will cause skin contraction. And at the same time, this builds collagen and elastin. And essentially, shrink wraps your skin to really outline the contours of the arm that we've achieved either with Emsculpt, with liposuction, or both. For this procedure, it's really very similar to having liposuction performed, and we often do it at the same time as liposuction. The one difference is that we do like you to wear a compression garment for about a month after this procedure to really help that skin shrink down and contract so that we can see that shape that we've been working towards.
[07:07] Now for people with a bit more severe skin laxity of the arms we talk about more invasive procedures where we're actually removing the skin. And with this we talk about something called a brachioplasty or arm lift. The far and away most common kind of arm lift is a procedure where an incision is made on the inside surface of the arm going essentially from the armpit to the elbow. And we use this to remove extra skin. Now this is a pretty major procedure and it does leave a real scar behind which usually does fade over time but you will always have some scar present and it's a fairly long scar. So this procedure is for people that really have severe skin excess and are willing to trade having that scar for an improvement in their skin excess. Now in some instances we can do what's called a mini brachioplasty.
[08:05] And this operation is really for people that have the majority of their skin excess kind of in the upper third of their arm. And for this procedure, instead of making one of these long incisions from essentially the inside of the shoulder to the elbow, we can actually make a much smaller incision, and that's just hidden in the armpit. So this is a great option for people that have just a little bit of extra skin kind of near their armpit or in the upper third of their arm. So together we have now addressed building that shape of the arm from essentially the ground up. The foundation is getting a really nice muscle tone with some Emsculpt and then uncovering that muscle tone by doing some targeted liposuction and then essentially making sure there isn't too much skin in the way to hide our result.
[08:56] And we do this usually with radiofrequency energy, the body type procedure, and in severe cases, we might talk about a brachioplasty. And the real art of achieving excellence in arm contouring is deciding which of these procedures a patient will benefit from the most, the right combination of procedures, if more than one procedure is necessary, and putting all that together in a way that is best aligned with the patient's goals. So I hope that this improved your understanding and gave you a kind of a way to approach the question of how can I improve the shape of my arms. And you can always DM me on Instagram or Twitter at NYCPlasticStock with any other questions that you have. Thanks for listening and don't forget to subscribe, share the show, and head over to darrensmithmd.com for more real-world plastic surgery talk.
Sources and context.
Original Captivate episode. Original release date: 2020-07-07. The recording is the source for the transcript and episode discussion. Later context in the written summary is identified separately.
Behind the conversation.
Darren M. Smith, MD, FACS