Candidates must be in good health, have no active diseases or serious, pre-existing medical conditions, and must have realistic expectations of the outcome of the surgery. In most cases, patients choose this procedure for cosmetic reasons, but in some patients sagging skin becomes so severe that the skin hangs down, creating what is called a “bat’s wing deformity.” This can restrict motion and interfere with the use of the arm. Patients considering brachioplasty should be aware that a significant scar will be present from the elbow to the armpit, and should not have the operation unless they feel comfortable with the scar or can wear clothes that hide it. This may involve a change of clothing styles, but in most cases the benefit of removing excess skin outweighs this issue.