The Tab Flap Technique Brachioplasty: Prevention of Contour Deformities

Abstract

Brachioplasty is defined as the contouring of the proximal upper extremity via excision of skin and underlying subcutaneous tissues. This procedure has become more commonly performed with the rise of bariatric and obesity-related surgery. A number of techniques have been described in the past, each with potential shortcomings, the most vexing of which are contour deformities or irregularities and constrictions such as the Michelin man deformity and short skin problems. The technique described makes it easier to avoid these complications and may be used alone or in conjunction with other techniques. The procedure begins with elliptical preoperative markings from the medial epicondyle to the axilla, centered on the medial inner arm. The initial incision is performed on the medial aspect of the preoperative markings. Flaps are then raised from medial to lateral. Once adequate undermining is completed, the skin and subcutaneous tissue are excised in a sequential segmental fashion to ensure the appropriate excision amount. This technique provides an excellent and reproducible result with outstanding upper extremity contour.