Background: A review of the results of the standard technique for "batwing" deformity after massive weight loss led to the need to optimize the cost/benefit ratio in terms of maximal correction/less visible scars.
Methods: Between 2001 and 2007, 29 patients were operated with a new technique based on a careful preoperative evaluation and markings, followed by an intraoperative skillful handling. This technique is not easy and needs plastic surgery experience and a long learning curve.
Results: The esthetic results are far better then those obtained with other techniques, especially the arm lower profile.
Conclusion: The complication rate is similar to other techniques, even if a potential low risk for ulnar nerve damage is present.