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■ Introduction 51 m

■ Upper-Arm Tightening 51

■ Anatomical Overview 53

■ Instruments 54

■ Duplicate Patient Information 58

■ Preliminary Examinations 58

■ Photographic Documentation 58

■ Surgical Planning 58

° ■ Preliminary Marking of Incision Lines 58

■ Mang's Fish-Mouth Technique 60

■ Positioning, Disinfection 60

■ Superficial Preparation 62

■ Deep Preparation, Hemostasis 64

° ■ Incision of the Dissected Dermofat Flap in Stages 64

■ Fixing of the Skin Flap with 3.0 Monocryl Key Sutures 66 o ■ Resection in Stages 66

■ Two-Layer Skin Closure 68

■ Cutaneous Sutures: Running or Intracutaneous 4.0 Monocryl 68 ° ■ Dressing 70

■ Literature 77

Introduction jg pl

Many patients who wish to improve the shape of their upper arms have a ™

considerable surplus of skin. The cause can be, for example, massive £

weight loss, but the process of skin aging can also leave such signs. In this case only excision can produce the desired improvement in the contour. Even the most careful upper-arm tightening, however, will result in a scar on the medial side of the arm, starting in the armpit and stretching as far as the elbow. The patient must therefore be informed accordingly because most patients want this procedure in order to be able to show their arms in public again.

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