It doesn’t seem to matter how many triceps exercises one does or if one reaches their ideal weight, the skin of the upper arms can defy the benefits of diet and exercise.

Age, weight loss and sun damage contribute to loosening of arm skin, as can smoking and unhealthy eating, and usually by the time people reach their 40s and 50s, the skin of the arm begins to sag.

The result is loose skin, with or without excess fat, that has often been referred to as “bat wings” by some. It is most noticeable when people wave or move their arms, and sometimes a crepe-like texture on the skin is present.

This can contribute to a droopier overall appearance of the upper body and make some people look much older than they are.

In an upper arm lift (a brachioplasty), the upper arm is reshaped by surgically removing excess skin. The length, location and shape of the incision depend on each person’s individual situation.

With expert and proper suturing technique, the result should be a fine hairline scar with no “stitch” marks. However, one must realize they are trading loose, saggy skin plus any excess fat for tighter skin with a fairly inconspicuous but present scar on the inside of each arm.

If skin and excess fat are the problem, a brachioplasty might be combined with liposuction. A liposuction can also be performed alone if the problem is only excess fat. Usually a liposuction with or without a brachioplasty is done under general anesthesia.

Results are visible almost immediately, although there will be swelling and bruising initially. Most of this subsides within the first few weeks, but the best results are seen 6 to12 months post-operatively.

For those with less skin to remove, there is now a minimally invasive procedure called ThermiTight. This method involves use of a radio-frequency instrument heated to a specific temperature, which tightens the skin as well as melts fat.

This is a one-time procedure with minimal discomfort and downtime and no scar. Liposuction is sometimes used in conjunction with ThermiTight procedures. ThermiTight is performed under local anesthesia.

Most requests for arm procedures naturally occur in the springtime when sleeveless shirts and dresses and tank tops are worn. Following upper arm procedures, many women report wearing outfits they have not worn in years.

There are a variety of surgical and non-surgical options for loose upper arm skin or excess fat. Each patient must be individualized. To assess your needs and explain the options for your informed choice, a board-certified plastic surgeon is the right start.

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton. www.fingerand