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Team Wellness World speaks to a panel of experts who reveal the latest non invasive as well as surgical procedures to treat this embarrassing, yet commonly occurring issue that affects nearly 1 in 5 women over the age of 35. 

woman with batwings


Call them what you like; bat wings, arm wings or just plain fat, baggy arms…but when you raise your arm and the skin under your arm jiggles in an embarrassing manner, then hey presto! – you have bingo wings!

The loose skin under your arms are caused by two main reasons mostly. When skin is stretched after a certain extent, it cannot retract which is what happens after excessive weight loss and also with ageing. As we get older, our body loses collagen and elastin, which causes sagginess and a lack of muscle tone which make bingo wings more obvious.

Another reason for bingo wings is genetics. Based on genetics, you may store more fat in the arms than other areas and since fat tends to accumulate in the arms when the body is overweight, and even with different exercises to target these areas, it takes time to build up and tone the muscle.

Another reason is linked to hormonal imbalances triggered by various factors such as medicines, contraceptive pills, menopause, pregnancy, breast feeding, abortion, or thyroid diseases. Even the sun, certain foods as well as habits can all combine to exacerbate damage to skin, and make it loose its suppleness.


The localized extra fat in the upper arm area is mostly resistant to diet and exercise. Avoid weight gain by cutting out all the bad carbs like white bread, white rice, cakes, and cookies, replacing them with lean protein like grilled chicken, oily fish like salmon and green, leafy vegetables and fruit.


beautifully toned armsNON-INVASIVE TREATMENTS

To tighten loose skin, we recommend Radio Frequency (RF) using Rejuve multi polar energy which penetrates the skin layers to selectively heat the skin tissue. The subsequent contraction of collagen fibres and the regeneration of the collagen and elastin, in turn tighten the skin layers.

Technique: Rejuve RF Skin Tightening uses radio wave technology to heat the deepest layers of skin without causing any of the skin damage associated with laser treatments. Each time the hand piece is activated over the skin, a warming sensation is felt, which once heated initially contracts the collagen in the deepest skin layer, stimulating new collagen production in the weeks following treatment. Rejuve takes between 30 and 45 minutes per session.

Results: Post treatment, the client feels slight tightness in the targeted area. After five to six sessions, a noticeable difference in appearance, shape, and measurement of the area treated can be seen–provided the client has been regular with the treatment protocol.


Velasmooth Pro combines four treatment modalities; namely Infrared Light (R), Radio Frequency, Vacuum and Mechanical Tissue Manipulation. This technology
uses heat for cellulite/fat treatment, promoting lymphatic drainage. Indicated for loose and flabby skin as well as cellulite, VelaSmooth can be done together with RF Skin Tightening for better results.

Technique: With the use of these four technologies, the Infrared Light heats the
tissue up to 3 mm depth while the Radio Frequency heats tissue up to 15 mm in depth specifically for skin tightening.

Results: Results are noticeable after 6 to 8 sessions with recommended maintenance sessions around once to twice a month and vary from one client to another.

The suffix ‘cryo’ is derived from the Greek kryos which Dr. Abdallah explains means ice-cold. “This is a technique developed at the Massachusetts General Hospital, USA following approval by Food and Drug Administration (FDA) and the American Academy of Cosmetic Surgery.

Technique: This treatment adopts cryo-lipolysis action to remove excess localized fat. Adipose (fat) cells are more sensitive to cold than the surrounding area, when cooled they undergo a process of slow and gradual spontaneous emptying, called ‘apoptosis’ or programmed cell death, then this lipids elimination from the human body happens through liver, the gastrointestinal tract and lymphatic system in approximately 15 to 20 days.

Ideal candidates for this treatment are individuals who want to reduce localised fat deposits; for instance on the abdomen, flanks, lower back, hips, thighs, and upper arms as these tend to be areas particularly stubborn to diet and exercise.

Results: Changes happen over several weeks; 12 weeks being the estimated time to see the optimal results, however even one session is sufficient for most areas.

In this treatment, an Infrared Skin Tightening Laser delivers a beam of high-intensity infrared light using a handheld nozzle that deeply penetrates the skin tissue. The light heats up the water content of your skin which stimulates the collagen in the skin, causing it to contract and tighten.

Technique: The NIR hand-piece emits near infrared light to deliver uniform energy distribution that target lipids and connective tissue to induce collagen shrinkage, dermal regeneration, repair and remodelling without damage to the epidermis,” she explains to tighten skin laxity.

Results: Immediate improvement following treatments; however further improvements develop gradually over a one to three months as new collagen is formed and skin tightens further.


Dr. Mario RussoIf non-invasive options haven’t necessarily delivered the results that you seek, then it’s the right time to consider surgical interventions. 


In the case of excess skin under the arms, a Brachioplasty or arm lift is recommended to address and correct this problem, explains Dr. Mario Russo, an Italian Board-Certified Plastic & Cosmetic Surgeon with 20 years of surgical experience in Europe, UK and Middle East.

“In a standard Brachioplasty, the inner sagging area of the arms undergoes liposuction followed by excision (surgical removal) of the excess skin,” and is often combined with other surgical procedures such as breast lifts, body lifts, or abdominoplasty. These types of procedures can help reshape the upper part of the arm after an individual has lost significant weight or in the case of ageing, whereby the skin has begun to lose elasticity.

Technique: Essentially there are varying techniques that impart different types of scars depending on the laxity of the skin and the incision used, explains Dr. Russo. “In case of liposuction alone there are very small scars involved while another imparts a scar from the elbow area to the arm pit in the inner part of the arm,” he says.

Results: Yields excellent results with upper arm contour but could leave behind a minor scar. 

According to Dr. Russo, there are two important elements to be considered when selecting the appropriate procedure for bat wings. “One is the amount of adipose tissue accumulated in the arms and second, is the degree of skin flaccidity in that particular individual,” he explains. In cases of mild excess arm fat deposits, especially with good quality skin, Dr. Russo says that liposuction would produce a good outcome.

Technique: This procedure is the intervention of choice in case of predominant accumulation of fatty tissue, with limited cutaneous hypotrophy, he says, adding, “The technique consists in infiltrating a solution that serves to facilitate the liposuction. Then a three mm sized cannula is inserted in the adipose tissue through small incisions at
the elbow and armpit, and the suction can start.” For mild to moderate cases, the procedure can be done under local anesthesia.

Results: An excellent improvement is always achieved. The expected results are fully explained and photos are shown to the patient during the consultation to ensure results match their complete expectations.

3. T-Brachioplasty (Full Brachioplasty)
A full arm lift or T-Brachioplasty, explains Dr. Russo, is a surgical procedure that removes loose skin from the arm where there is severe laxity. “This can help to reshape the inner and posterior areas of the arm especially after significant weight loss,” he says.

Technique: This is usually performed under general anaesthesia or local anaesthesia/ sedation. The amount and laxity of the excess skin determines the placement of the scars. “In the case of a predominantly vertical axis laxity, a longitudinal scar is used,” so in these cases more skin is removed and the scar will be placed along the inside or back of the arm. The fat will be removed through liposuction. “The other is a T-shape scar for a more severe situation where there is skin laxity in both horizontal and vertical directions.” Therefore, besides using liposuction to remove volume, it necessary to remove skin in both axis, resulting in a longitudinal scar along the inside of the arm and a transverse scar in the armpit, known as a ‘T’ shaped scar. An extended scar may also be used in cases
of extreme skin laxity. “Here it is necessary to combine both incisions and even extend the scar into the chest wall.”

Results: Results are consistent and long lasting if the patient maintains stable weight and exercises.

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