Waving Goodbye to Flabby Arm Fat

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Flabby arms are perhaps one of the most unattractive parts of the body that can make one very self-conscious. Everyone wants to wear a sleeveless vest on those sweltering hot days, while showcasing their sculpted and toned arms with smooth, taught skin. Unfortunately our arms often give away our true age, and the quality of the skin deteriorates over time.

Dr Natasha Chapman advises on how to rid ourselves of our jiggly arm wings…

The cause of flabby arms is multi-factorial.  One needs to first determine whether the flabbiness is due to an excess of fat, muscle or skin laxity, deterioration in the quality of the overlying skin, or a sheer excess of loose skin.  The good news is that there are various treatments available for improving the appearance of flabby arms; however the cause of the problem must be addressed first.

Patients who carry a significant excess of weight often store large amounts of fat in their upper arms, which become flabby with age.  Even with weight loss, the flabbiness persists as the skin has previously been stretched to accommodate large pockets of fat.  Some patients have a genetic predisposition to storing fat in their upper arms, and a consultation will elicit a history that other family members suffer from the same problem.

Large amounts of fat in the arms can be removed with treatments such as liposuction, but this often leaves an excess of loose skin.  Laser liposuction may give more pleasing results as there is also a degree of skin tightening that occurs due to the heating of the tissue. This heat stimulates collagen tightening and new collagen synthesis.

Non-invasive treatments such as Coolsculpting, the fat freezing procedure by Zeltiq, can help remove 20-40% of fat in the area treated. The new Liposonix ultrasound fat removal treatment can also help break down fat, as well as offer a degree of skin tightening. Both of these treatments have FDA approval for fat reduction.

Treatments such as Velashape and Velasmooth may help reduce the circumference of large arms.  Combination treatments such as synergy or endermology – coupled with carboxy therapy, often give fantastic skin-smoothing effects on cellulite. It may also well improve the look of fatty pockets or dimpled arms.  The mechanism of action is the same: Increased blood flow and improved lymphatic drainage of the area.  Usually the effects are short-lived, lasting anywhere from a few weeks to several months… unless maintenance treatments are continued.

Patients who have a history of intense gym workouts with arm building exercises, often find their muscles slacken later in life. Their beautifully toned arms of their youth become soft and flabby… even when they aren’t carrying any excess weight. Daily muscle tightening exercises such as triceps curls will help tighten muscles again.  My suggestion to patients is that they start out with mild exercises – and gradually build up the intensity.  Leaning slightly forward whilst standing, extend one arm backwards and upwards. Keeping the elbow up, bring your hand forward in a fist to touch the anterior shoulder. Repeat this tricep tightening exercise 20 times on each side, gradually building up to 40 repetitions daily.  Then, add a small 1kg weight (or just a tin of food) into your daily ritual.  Keep the weights light as the aim is toning rather than muscle building.

Flabbiness caused by the deterioration in the quality of the overlying skin leads to a crepey appearance of the arms. There are a few factors that contribute to this.  As we age, we lose some of the subcutaneous fat that helps to plump out the skin.  The amounts of collagen and elastin decrease, leading to a decrease in elasticity. Our skin also produces less hyaluronic acid, thus leading to decreased hydration.

Tissue tightening treatments such as ThermageTitan, and Ulthera can improve the appearance of crepiness.  These treatments work by heating the underlying dermal tissue.  Heat stimulates a degree of collagen tightening, as well as stimulating fibroblasts to produce new collagen.  The overall quality of the skin improves with both the tightening and tissue building effects, with results taking a few months to become apparent.

Thermage uses radiofrequency and has long been considered the gold standard in tissue tightening for skin on the body.  It can be used on arms as well as other difficult-to-treat areas such as knees, inner thighs and abdomens.  Traditionally, this treatment was very painful and expensive, but the costs have recently come down and the newer machines are now able to offer treatments which are a lot less painful – while still offering the same results.  Ulthera (which imparts energy by ultrasound pulses) has just been granted FDA approval for tightening the skin on the arms, which is an exciting new application for this tissue tightening treatment.  Other skin tightening treatments such as Accent and Tripollar radio frequency cost a fraction of the price, but are unable to impart as much energy. However, they may have some benefits in skin tightening.

Crepey skin on arms caused by a decrease in hyaluronic acid can be improved with the injection of hyaluronic acid based fillers.  Products such as Juvederm Hydrate and Restylane Vital are non-cross linked fillers designed especially to hydrate the overlying skin. Their hydroscopic nature enables them to draw in large amounts of water, leading to an increase in hydration of the overlying skin.  Hundreds of small droplets are injected just beneath the surface of the skin to improve the appearance.  These fillers don’t last as long as normal fillers and treatments need to be repeated every few months to maintain the benefits.

Large amounts of excess skin that is a result of massive weight loss can only be removed surgically by a plastic surgeon.  The results can be impressive, but there is a significant amount of scarring caused by large excisions – making it unsightly to wear sleeveless garments (despite the removal of fat and loose skin). This is however the most effective option if the flabbiness is significant, and will enable arms to look good in long-sleeved clothes.

My advice to patients with mild to moderate flabbiness of the arms is to explore non-surgical treatment options for an improvement in the appearance of their arms.  A degree of improvement is usually always possible with carefully selected, appropriate treatments for the specific problem.  Patients with severe flabbiness, whether it is caused by excess fat, muscle slackness, or loose overlying skin, should rather explore a more invasive, surgical option for best results.

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