Female Arms

and Peter M. Prendergast²

(1)

Elysium Aesthetics, Bogota, Colombia

(2)

Venus Medical, Dublin, Ireland

Introduction

The beautiful female arm displays a subtle balance between slimness, softness, and definition. The arm should appear slim but not skinny, and certain muscles should be visible, but not others. For instance, the deltoid outline is desirable, and some definition of the biceps is acceptable. However, a developed triceps is perceived as a masculine feature, so it is not appropriate to display and define this muscle in the female arm (Fig. 17.1).

Fig. 17.1

Athletic slim female arms

Although the aesthetic ideal described above is generally accepted as the goal in lipoplasty of the female arm, each patient has her own conception of beauty [1]. Some women want very slim arms with little muscular definition and others want accentuation of the deltoid shape, while others want a masculine look. The preoperative assessment plays a crucial role in determining the wishes and expectations of the patient. During the consultation, it is helpful to ask the patient about some of their favorite star’s arm shape. Some will mention Angelina Jolie (slim), while others would say Jessica Biel or Cameron Diaz (toned, deltoid outlined) and others will say Madonna (very athletic, deltoid and biceps outlined, almost masculine).

Stealth Incisions

The incisions are made with the patient in the prone position, with a 90° arm abduction, 90° elbow flexion, and complete external rotation.

Three 5 mm incisions are used: in the posterior axillary crease, in the anterior axillary fold, and at the elbow over the olecranon tip (Fig. 17.2).

Fig. 17.2

Female posterior arm incisions with ports

The Use of Drains

Drains are not needed. As in the male approach, the distal incisions at the elbows are left open for permissive drainage. Early postoperative massage should be implemented to facilitate drainage.

Markings

The markings are best drawn with the patient in the standing position. Compared to the markings in the male patient, the female arm markings are relatively easy.

Deep Markings

With the patient’s arm in adduction, first, the excess fat over the posterior aspect of the arm is marked. In some women, significant fat deposits are located in the internal portion of the arm [2]. These are marked with the arm in abduction. It is important to mark all the posterior fat distally and proximally and mark the mid posterior arm for cautious extraction.

The Youth Angle

As in male patient, the inferior border of the female arm with the arm in 90° abduction forms the “youth angle.” The more acute the angle is, the more pronounced the triceps muscle mass and the younger the arm looks. In obese and older people, the angle tends to be obtuse due to the presence of extra fat and/or laxity of skin (Fig. 17.3).

Fig. 17.3

Female youth angle in the anterior (a) and posterior (b) views

Framing

With the arm in 90° abduction and 90° elbow flexion, mark the posterior deltoid muscle sulcus. The triceps is not marked, as the ideal female arm does not have significant muscle mass in that area. In some patients, the intermuscular crease between the biceps and triceps is marked, both anteriorly and posteriorly.