[Arm liposuction] Why does my upper body look especially large? Could poor lifestyle habits be the reason?
Hello, this is Dr. Yongseung Seo at Lesarts Plastic Surgery.
Why does the upper body look especially large?
Is it caused by poor lifestyle habits?
To start with the conclusion,
in most cases, upper-body weight gain
is not caused by lifestyle habits.
It is largely genetic.
The same applies in reverse.
If weight tends to accumulate in the lower body,
it is not anyone’s fault.
It is most often due to genetic predisposition.
One of the most common frustrations
we hear in the consultation room
from patients concerned about a bulky frame
is this question:
“Why won’t my upper arm fat go away?”
No matter how hard they diet,
fat in that area does not decrease.
And even after losing weight with great effort,
a brief lapse often leads to fat returning
to the upper arms first.
As mentioned earlier,
those who gain weight in the upper body first
are usually born with that body type.
So even if they try to burn off this fat through dieting,
fat is often lost first from unwanted areas
such as the face, breasts, or hips,
creating additional stress.
In the end, dieting alone often fails.
Do you find that everything else gets slimmer,
but your upper arms remain unchanged
no matter how much you diet?
In such cases,
choosing liposuction can be a decisive option
to free yourself from ongoing stress.
Today, we will look at a case
where arm, surrounding arm, and bra-line liposuction
helped resolve concerns about a bulky upper body.
[Patient information]
Age: Late 20s
Height: 165 cm
Weight: 71.4 kg
BMI: 26.2
Body fat percentage: 38%
Even patients with similar specifications
may experience different results from liposuction surgery.
[Preoperative body assessment for arm, surrounding arm, and bra-line liposuction]
The patient had consistently engaged
in light cardio-focused exercise.
However, there was little visible improvement
in the arm line,
and the bulky overall frame remained a concern.
After a recent trip, her weight increased further,
and she visited our clinic
to reduce the now thicker upper arm fat.
Before arm liposuction surgery
The patient had a significant amount of fat on the back of the arms,
commonly referred to as “wing fat” or “jacket fat.”
When the arms were lowered, this fat was pushed outward by the torso,
causing it to protrude and making the overall frame appear even bulkier.
Naturally, when the arms were raised,
the weight of the fat caused the upper arm tissue
to sag noticeably downward.
Even with the arms lowered,
the side view showed pronounced bulging at the back,
making the arms look especially thick.
There was also a moderate amount of fat
around the scapular area and along the bra line,
creating an uneven appearance across the back
and further contributing to a bulky silhouette.
Although not excessive,
fat in the accessory breast and axillary areas
also affected the overall upper-body volume.
For this reason, we recommended liposuction
targeting not only the arms,
but also the scapular area, bra line,
accessory breast, and underarm regions.
Ultrasound examination showed
a substantial amount of fat:
Back of the arm: 21 / 20 mm
Front of the arm: 13 / 15 mm
Scapular area: 11 / 14 mm
Bra line: 13 / 14 mm
In addition, the shoulder muscles were highly developed
at 25 / 21 mm,
so we explained that achieving a perfectly right-angled arm contour
would be difficult.
We also informed the patient
that because there was a difference
in muscle size between the left and right sides,
some asymmetry in arm thickness and contour
could remain after arm liposuction.
Although the patient had several concerns
before deciding on surgery,
she chose to proceed after trusting
a successful case experienced by an acquaintance
and our assessment that “a higher fat volume
would lead to more visible results.”
After arm liposuction,
as the previously thick fat layer is removed,
the overall upper-body volume is expected to decrease significantly.
While a slight asymmetry may remain,
with the right shoulder appearing somewhat larger,
we expected the bulky “heavy frame” impression
that concerned the patient most to disappear,
allowing her to regain a slimmer, more delicate silhouette.
Arm and back liposuction surgical approach – Lesarts Plastic Surgery – Dr. Yongseung Seo
[Design strategy to make the frame look as small as possible]
Ultimately, to make the overall frame appear smaller,
it is necessary to reduce the left–right width of the torso
as well as the width of the upper arms.
In fact, when viewed from the front and back,
the fat that protrudes the most outward
is not the fat on the side of the arms,
but the fat on the back of the arms
(so-called wing fat or jacket fat)
that rotates outward.
Addressing this area is the top priority.
However, if all posterior arm fat is removed,
it becomes contrasted against the relatively thin tendon area
of the deltoid muscle,
making the upper arm appear thicker from the side.
For this reason, fat over the tendon area
should be preserved in harmony with the muscle.
Once the posterior fat is addressed,
the outer arm line must be refined.
By identifying the most protruding point
of the shoulder muscle (deltoid),
which is the outermost structural element of the body,
and shaping inward from that reference point,
it becomes possible to achieve
the slimmest natural line for the individual.
If all outer fat is removed, however,
the boundary between the deltoid and triceps
can become too visible,
causing the muscles to stand out
and creating an optical illusion
that makes the arms look thicker.
Therefore, fat in this area should be preserved
to create a straight, clean line.
The scapular and bra-line areas
are among the regions with the lowest risk of complications
when performing liposuction.
For this reason, we planned to remove fat
up to the maximum safe range.
That said, because the skin in these areas is quite thick
(which also contributes to fewer complications),
we explained in advance that even after fat removal,
the tissue may still feel somewhat firm when grasped.
In addition, although these areas are not essential
for reducing the bulky frame,
the patient expressed a desire
to wear sleeveless summer clothing attractively.
For this reason, accessory breast
and axillary fat were also addressed.
We explained that aggressive removal of accessory breast fat
could lengthen or deepen underarm creases,
and in some cases,
an additional crease line may form.
[Before-and-after comparison of arm, surrounding arm, and bra-line liposuction]
(Photos taken two months after surgery
under the same lighting and environment)
The patient stated that
“my frame looks bulky, the surrounding areas are distracting,
and I want a clean, straight arm line.”
Based on these goals,
the surgery was planned and performed accordingly.
Upper body shape changes before and after arm liposuction – Lesarts Plastic Surgery – Dr. Yongseung Seo
1. Outer arms:
The outward-protruding fat was fully refined,
resulting in a smoother contour
and a slimmer arm shape.
While the difference in left–right thickness
was not as pronounced as initially expected,
a subtle asymmetry in the arm lines
does remain.
Arm liposuction before and after – Lesarts Plastic Surgery – Dr. Yongseung Seo
Scapular and bra-line liposuction before and after – Lesarts Plastic Surgery – Dr. Yongseung Seo
2. Back of the arms:
The sagging fat that appeared when the arms were raised
and the bulging fat that protruded backward when the arms were lowered
were eliminated.
With the removal of the previously uneven fat
along the scapular and bra-line areas,
the overall body line became smoother,
cleaner, and more refined.
Arm circumference difference before and after arm liposuction – Lesarts Plastic Surgery – Dr. Yongseung Seo
3. Front of the arms:
While the overall line itself did not change dramatically,
there was a clear reduction in size
when viewed from the shoulder joint,
and the transition appeared noticeably smoother.
4. Accessory breast area:
The outward bulging tissue that had covered
the starting line of the arms was eliminated.
However, as explained preoperatively,
short crease lines did appear.
5. Underarm area:
The previously bulging, heavy-looking underarms
moved inward, creating a slimmer, cleaner impression.
The before-and-after photos of arm liposuction above
were taken two months after surgery.
Over time, the results will continue to settle,
becoming smoother and more delicate in appearance.
Diet methods such as aerobic exercise
are helpful for overall body fat reduction.
However, because fat loss follows
a genetically determined order,
it is impossible to selectively remove fat
from only one specific area.
Rather than repeating the cycle
of extreme dieting and giving up,
using surgical or non-surgical treatments
can sometimes be a more efficient way
to save time, effort, and cost.
If you are troubled by stubborn fat
that simply will not go away,
why not take this opportunity
to consult with a specialist?
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